YBF WPF CORNELL UNIVERSITY ~ LIBRARY THIS BOOK IS ONE OF A COLLECTION MADE BY BENNO.ZOEWY i 854-1919 XND BEQUEATHED TO “CORNELL UNIVERSITY a Cornell University Library RC 439.W77 iil of lunacy; a handbook relating wi olin A HANDBOOK RELATING TO THE LEGAL CARE AND TREATMENT OF THE INSANE, MANUAL oF LUNACY: A HANDBOOK RELATING TO THE LEGAL CARE AND TREATMENT OF THE INSANE IN THE PUBLIC AND PRIVATE ASYLUMS OF GREAT BRITAIN, IRELAND, UNITED STATES OF, AMERICA, AND THE CONTINENT. BY LYTTLETON 8S. WINSLOW, M.B. & M.L. Cayras., M.R.C.P. Lonp., D.C.L. Oxon. WITH A PREFACE BY FORBES WINSLOW, M.D., D.C.L. Oxon. ETC, ETC. LONDON: SMITH, ELDER, & CO., 15 WATERLOO PLACE. 1874. All rights reserved. Re 424 Abs’ 679 ‘TO HER MAJESTY’S COMMISSIONERS IN LUNACY This Work is Respectinlly Wedicnted BY THEIR OBEDIENT SERVANT THE AUTHOR. PREFACE. — At the desire of the publishers and author of this work, I have undertaken, by means of a short Preface, to introduce it to the members of the Légal and Medical professions. . It is scarcely necessary to say that it affords me much pleasure to accede to their request, and thus assist in the début of my son, about making (to quote the language of Lord Byron) his “ first dash into literature.” I am glad of the opportunity of advancing with him to the footlights of the great stage of letters, and, after an affectionate grip of the hand, and a few cheering and stimulating words, leave him to the kind judgment of his audience—the critics. The author has compiled this volume with great care and unflagging industry. I have glanced through the proof sheets and found the data accu- rate. I believe the book will be of great value as one of reference to lawyers as well as to all per- sons associated with lunatic asylums, and interested in the legal care of the insane. During the progress of the work, the author has viii PREFACE communicated with the most distinguished conti- nental alienists, as well as with the lunacy officials of Scotland and Ireland, and they have kindly placed at his disposal much valuable information relative to the laws regulating the confinement of the insane in their respective countries, which has been em- bodied in these pages. He hopes that this volume will fill a gap exist- ing in medico-psychological literature. No medical practitioner having access to it can for the future plead ignorance of the law as an excuse for its vio- lation, as he will find here clearly specified every- thing that he is required to know in regard to the legal confinement of persons (paupers as well as others) alleged to be of unsound mind, not only in licensed, but unlicensed, houses as “ single patients.” The author has also drawn attention to the docu- ments the physician is required to arrange and sign, in conformity with the provisions of the Lunacy Acts,. previously to, and after, placing a patient under re- straint. Instructions are also given for drawing up the official records necessary to be kept by the resi- dent medical or non-resident medical officer of an asylum, and suggestions are made as to the mode of signing the medical certificates, order, and state- ment, authorising the use of restraint, and of filling up the reports it is obligatory for the medical officer to make, for the inspection of those appointed by the government to visit asylums, and to report as to their condition. But, what is of more importance tothe busy prac- PREFACE ix titioner (who, in moments of difficulty, may have no authoritative work at hand to consult, and no experienced legal friend on the spot to whom he may apply for information), he will find pointed out in this volume the rocks and dangerous quicksands to be avoided; in other words, he can easily ascertain what he may, and may not, do in reference to the confinentent and detention of persons alleged to be mentally unsound, and fit subjects for surveillance. The “pains and penalties ” to which he makes: himself liable for any infraction of the lunacy laws are here distinctly detailed, so that he who runs may read and understand his responsible duties when called upon to assist in temporarily curtailing the liberty of a person on the plea of his being mis- chievously insane, and consequently unfit to be at large, govern himself, or to manage his own affairs. The reader will also find in this manual valuable statistical facts relating to the insane in this and other countries, with an account of the principal asylums, public and private, the names of the pro- prietors, resident and consulting medical officers, and information with regard to the scale of charges for the maintenance of the patients, as well as instruc- tions for obtaining ready admission for these afflicted persons, should it be necessary to place them under “care and treatment” in asylums specially or- ganised for their reception. ; The author has analysed the Acts-of Parliament that refer to Commissions of Lunacy and Chancery patients, and briefly indicated the course to be x PREFACE p pursued should it be nécessary to petition the Lord Chancellor to issue a writ De Lunatico Inquirendo, in order to enable the Court to protect and admi- nister the property of insane persons. In the final chapter are delineated the charac- teristic symptoms of the various phases of insanity, which the physician has to describe when certifying to a person’s mental derangement prior to his being placed under restraint, with a short explanation of the nosological terms representative of particular types of insanity which he will be required to define, when giving evidence in a court of law as to the existence of the unsoundness of mind of persons accused of crime, or alleged to be deficient in testa- mentary capacity. I wish to add two or three words in conclusion. I offer no apology for saying, what the diffidence of the author would obviously preclude him from stating, that he has brought to the composition of this work a considerable amount of knowledge acquired from a careful:study of the literature of insanity, as well as valuable practical experience regarding the laws regulating asylums and the con- finement of insane persons, from his having resided for several years in my establishment\at Hammer- smith, and taken an active part in its management. Forses Winstow, M.D. CavenpisH Square: October 1873. CONTENTS. CHAPTER I. HISTORY OF LUNACY LEGISLATION. Recognition of Insanity by the Ancients—Madness of Saul and David—Asylum at Jerusalem, 491—House of Grace at Bagdad— Property of Lunatics formerly under the Care of Tutores—Treat- ment of Lunatics in the Olden Time—Operation on a Lunatic, 1660 —Insanity in the Reign of Elizabeth—Bethlehem Hospital, when founded—St. Luke’s Hospital, when founded—First Lunacy En- actment, 1744—Committee of House of Commons, 1763—Lunacy Act, 1774—Lunacy Act, 1818—Committee of House of Commons, 1814—Lunacy Act, 1828—Lunacy Act, 1845—Lunacy Amend- ment Act, 18538-1862 : is 7 ae Ny Pages 1-18 , CHAPTER II. PRESENT STATE OF LUNACY IN ENGLAND AND WALES. Commissioners’ Report, 1872—Statistics of Insanity—Institutions for the Insane—Average Cost of Patients in County Asylums—Sta- tistical Tables. : i. . . . , : 19-27 CHAPTER IIi. EPITOME OF THE LUNACY ACT. Masters in Lunacy—Commissioners in Lunacy—Jurisdiction of Commissioners in Lunacy—Visitation of Commissioners—Enqui- ties made by Commissioners—Night Visitation by Commissioners —Single Patients—Property of Lunatics—Visitation of Gaols and Workhouses—Dangerous Lunatics—Discharge of Lunatics by Commissioners—Licences for Asylums—Duration of Licence— Cost of Licence—Residence of Licensed Person in Asylum—Death of the Licensee—Refusal to Renew Licence . 3 - 28-40 xii CONTENTS CHAPTER IV. ON THE MANAGEMENT OF ASYLUMS AND LICENSED HOUSES. Admission Book—Case Book—Statement—Discharge of Patients— Death of Patients—Medical Journal—Official Books kept at Asy- lums—Commissioners’ Entries—Escape of Patient—Transfer of Patient—Boarders in Asylums—Correspondence of Patients— Ill-treatment of Patients—Unjust Confinement of Persons—At- tendants in Asylums—Notices of the Engagement and Discharge of Attendants . ‘ . 5 - * . Pages 41-55 CHAPTER V. PRIVATE PATIENTS. ‘ Order for Admission into an Asylum—Statement of Admission— Medical Certificates— Discharge of Patients in Consequence of in- sufficient Facts—‘ Facts of Insanity” observed by the Medical Man signing—* Other Facts ” communicated to him by Friends of the Patient—Instructions for filling up Medical Certificates as issued by the Commissioners of Lunacy—List of Metropolitan and Provincial Private Asylums . . ‘ ‘ i 56-81 CHAPTER VI. SINGLE PATIENTS CONFINED IN UNLICENSED PRIVATE HOUSES. Statistical Table of Single Patients—Provisions of the Law relating to Single Patients—Preliminaries necessary for the Reception of Single Patients—Medical Visitation Book—Notice of Death— Notice of Discharge—Counsel’s Opinion on certain Matters relating to Single Patients—Lord Shaftesbury’s Remarks on Single Pa- tients . a Sg . ; . . : : - 82-93 CHAPTER VII. PAUPER LUNATICS. Meaning of Term (Pauper)—Preliminary Steps for the Admission of Pauper Lunatic into County Asylum—Section of Act referring to Admission of Pauper Lunatic into County Asylums — Pauper Lunatics in Licensed Houses—In Workhouses—Provision as to Lunatics wandering at large—Number of Patients in Cotnty and Borough Asylums, and Average Cost per Head A 94~110 CONTENTS : xiii CHAPTER VIII. COMMISSIONS IN LUNACY AND CHANCERY LUNATICS. Ancient Mode of dealing with Property of Persons of Unsound Mind —Lord Coke’s Classification of Persons non compos mentis— Object of a Commission in Lunacy—Preliminaries prior to Commission— Petition for Enquiry—Affidavits in Support of Enquiry—Enquiry conducted by Jury—Enquiry without Jury—Opposition of Com- mission—Power of Commissioners to enquire into Lunatic’s Pro- perty—Form of Subpeena for Attendance of Witnesses at Commis- sion—Evidence of Witnesses residing Abroad—Mode of conduct- ing Commission—Appointment of Committees—Duties of Com- mittee of the Person and of the Estate—Death or Retirement of Committees—Proceedings for dealing with the Property of Luna- tics when it does not exceed 1000/., or the Income 602. per annum —Single Chancery Patients—Visitors of Chancery Lunatics— Lunatics beyond the Jurisdiction of the Court—Supersedeas of Inquisition — Traverse of Inquisition — Chancery Patients in Licensed Asylums . A ‘ Z . . Pages 111-139 CHAPTER IX. ST, LUKE'S AND BETHLEHEM HOSPITALS FOR LUNATICS. Regulation respecting the Admission of Patients—Charges for Pa- tients— Questions required to be answered prior to the Admission of Patients—Instructions to Persons applying for the Admission of Patients—List of Clothing required by each Patient—Order for Admission—Medical Certificates—Bond necessary to be signed. Bethlehem Hospital—List of Patients—lInstructions relative to the Admission of Patients—Persons who are eligible for Admis- sion—Certificate given by the Minister of the Parish that the Patient is a proper Object for the Charity—Bond on Admission— List of Clothing required by each Patient—Order for Admission —Statement—Medical Certificates . 3 i i 140-159 CHAPTER X. LIABILITIES INCURRED BY THOSE CONCERNED IN THE CONFINEMENT OF PERSONS ALLEGED TO BE INSANE. 1 Liabilities of Proprietors and Medical Superintendents—Infringe- ment of the Law by receiving a Patient without Order—Statement and Certificates—Liability of Person signing the Order for Ad- xiv CONTENTS mission—Liabilities of Medical Men who sign the Certificates— Discharge of a Patient by Commissioners in consequence of an Ilegality in one of the Medical Certificates—Action against an Unregistered Practitioner for signing a Certificate. Pages 160-169 CHAPTER XI. LUNACY IN SCOTLAND. Form of Statement for Admission lodged with Petition to the Sheriff —Medical Certificate—Order granted by Sheriff—Notice of Ad- mission—Medical Report respecting Patients in Asylums—Resi- dent Medical Officers—Discharge of Patients—Register of Luna- tics—Death of Patients—Boarders in Asylums—Single Patients in.Private Houses—Correspondence of Patients—Commissioners in Lunacy—Statistics of Insanity in Scotland—List of Private and Public Asylums - . : : : : 170-189 CHAPTER XII. LUNACY IN IRELAND. Particulars relative to Licences—Statement and Order for Admis- sion—Medical Certificates—Notice of Admission—Entry Book of Patients kept at Asylums+Escape, Removal, or Death of Patients—Visitation of Asylums by Inspectors—Single Patients in Unlicensed Houses—-Commissions in Lunacy—Inspectors in Lunacy—Statistics of Insanity in Ireland—List of Public and Private Asylums. . : ‘ ‘ : 3 190-202 CHAPTER XIII. LUNACY IN FRANCE. Departments in France to contain Asylums—Regulations respecting Asylums—Appointment of Medical Officers to Asylums—Licences —Voluntary Patients—D’ Office or Judicial Lunatics—Alleged Cases of Insanity—Statistics of Insanity in France—List of Asy- lums in France—Private Asylums in Paris and its Vicinity— Commissioners in Lunacy ‘ ‘ ; . ‘ 203-214 CHAPTER XIV, : LUNACY IN BELGIUM. Licences— Admission of Patients into Asylums—Medical Certificates Notice of Admission—Visitation of Patients—Single Patients— CONTENTS xv Discharge of Patients—Classification of Lunaties—Medical Offi- cers of Asylums—List of Asylums in Belgium—Insane Colony at Gheel—Statistics of Insanity in Belgium . Pages 215-232 CHAPTER XV. LUNACY IN GERMANY. Particulars relative to Asylums—List of Asylums belonging to the German Confederation—Public and Private Asylums at and in the Neighbourhood of Berlin —Statistics of Insanity in Germany. 233-242 CHAPTER XVI. LUNACY IN UNITED STATES OF AMERICA. Condition of Lunacy in America—-List of Asylums in America— Statistical Tables. : . ‘ . 5 j 243-246 CHAPTER XVII. LUNACY IN RUSSIA. Particulars relative to Asylums . i ‘ . , 247-248 CHAPTER XVIII. | RECENT LUNACY STATISTICS AND INSTRUCTIONS, Statistics of Insanity on July 1st, 18783—Particulars relative to New County Asylum in Middlesex—lInstructions recently issued for the Guidance of Persons signing the Order and Medical Certifi- eates with certain’ Cautions—Changes in the Commission— Patients in Asylums—Remarks by the Commissioners on Private Asylums—Remarks on Seclusion—Important Remarks by the Commissioners on Single Patients-—Regulations respecting the De- tention of Persons of Unsound Mind in Workhouses—Statistical Tables of Insanity on the Continent . ‘ . 249-267 : CHAPTER XIX. DEFINITIONS AND EXPLANATIONS OF TERMS. Mania, Acute, Chronic, and Recurrent—Monomania—Melancholia, Acute and Chronic—Dementia, Acute and Chronic—Imbecility— xvi APPENDICES Idioey—Nymphomania—Kleptomania—Delusions, Hallucinations, and Illusions—Delirium—Dipsomania—Homicidal and Moral Insanity—Puerperal Insanity—General Paralysis of the Insane— Feigned Insanity and Medical Evidence in Court. Pages 268-298 , APPENDICES. LUNACY ACT, 1845, 8 anv 9 Vicr. c. 100. Appointment of Commissioners in Lunacy—Particulars relative to the Commissioners in Lunacy—Secretary to Commissioners—Ap- pointment of Clerks—Oath taken by Commissioners—Jurisdiction. of Commissioners—Licences—Special Meetings of Commissioners —Visitor of Asylums beyond the Jurisdiction of the Commissioners in Lunacy—No Commissioner, Visitor, or Secretary to act as such if interested within one Year in a Licensed House—Alteration of Asylum—Noticeto be given to the Commissioners—Licences granted by Justices—Rénewal of Licence, what to contain—Licence to be made out in a given Form—Charge for Licence—Annual Accounts made out by Secretary of Commissioners and Clerk of the Peace— Provision when the Person licensed is dead or incapacitated— Provision when Licensed House is rendered unfit by Fire or other- wise—Revocation of Licence—Hospitals containing Lunatics to jhave Printed Regulations and Medical Attendant—Licence re- quired for two, or more than two, Patients—Book of Admissions—. Notice of Admission of Patient sent to the Commissioners—Notice . of Escape sent to Commissioners—Statement of Death sent to Commissioners—Ill-treatment of Lunatics—Residence of Medi- cal Officers in Licensed Houses—Medical Visitation Book in Licensed Houses—Case Book—Visitation of Licensed Houses by the Commissioners—Licensed Houses beyond the Jurisdiction of the Commissioners inspected by Visitors—Commissioners at Visi- tation to examine House and all Lunatics therein confined—Enqui- : ries made by Commissioners at their Visitation—Official Books: placed before Commissioners —Visitor’s Book—Patient’s Book— Copy of Official Entries transmitted to Board—Doubtful Cases to be mentioned in Patients’ Book — Visiting Commissioners’ Report to Commissioners in Lunacy.of Houses not within the immediate Jurisdiction of the latter—Power of Commissioners to make Rules—Visitation of Asylums by Night—Who er authorise the Discharge of a Patient from an Asylum—Dis-| APPENDICES xvii charge of Pauper Lunatics — Discharge of Dangerous Luna- ties prohibited—Discharge of Patients by Commissioners—Visita- tion of Doubtful Cases of Insanity by Commissioners and Visitors respectively—Regulation of Dietary of Pauper Lunaties—Infor- mation given by Visitors and Commissioners as to the Detention of a Lunatic in an Asylum—A Commissioner or Visitor may give an Order for the Admission to any Patient of a Friend or Relative —Temporary Leave of Absence of Patients--The ‘“ Order” for Admission to remain in Force for Fourteen Days in the Event of an Escape—Commissioners to report to the Lord Chancellor periodically—Single Patients in Unlicensed Houses—Commis- sioners to report to Lord Chancellor if the Property of Lunatics is not duly protected—The Master in Lunacy instructed by the Lord Chancellor to enquire into the Property of Lunatics, and to appoint Committees —Proprietors and Superintendents may plead Order and Medical Certificate in bar of all Proceedings at Law— Witnesses summoned by Commissioners to give Evidence in any : Matter required—Conviction for Offences against the Act—Appeal to Quarter Sessions—Action to be commenced within Twelve Calendar Months—Prosecution of Offenders against the Act by Commissioners—Copy of Official Documents miscarried—Cost incurred by Commissioners; how met—Visitation of Gaols and Asylums by Commissioners—Visitation of Lunatics under Care of Committee—Visitation of Criminal: Lunatics—Power of Lord Chancellor and Secretary of State to authorise the Visitation of Lunatics—Meaning of the various Terms used in this Act— Schedule—A. Form of Licence—B. C. D. repealed—E. Registry of Admissions—F. superseded—G. 1. Register of Discharges and Death—G. 2. Form of Notice of Discharge or Death — H. superseded—I. Form of Summonses : » «+ 299-360 Il. LUNACY ACT, 1853, 16 & 17 Vict. c. 96. Residence of Licensed Persons—No Person not a Pauper to be re: ceived into a Hospital or Licensed House without Medical Certi- ficates and Order—Provision where Patients may be received on one Medical Certificate only—Boarders—Pauper Lunatics received on one Medical Certificate—Single Patients—Penalty for IIl- treating Lunatics—* Facts” to be stated in Medical Certificates —Amendment of Order and Medical Certificates—Persons prohi- bited from Signing the Order and Certificate—A False Certificate a Misdemeanour—Power of Commissioners to lessen the Number of Medical Visits made to Single Patients—Visitation of Single Patients by Visitors —Aunual Report of Medical Visitors of a xviii APPENDICES Single Patients—Provisions respecting the Discharge of Single Patients—Lord Chancellor empowered to authorise the Discharge of Single Patients—Notice in the Event of the Recovery of a Pri- vate and Pauper Lunatic to be given to the Friends and Guar- dians—Provision in Case of Death—Transfer of Private and Single Patients to Asylum—Notice of Discharge. of Single Patients ~—Change of Residence or temporary Removal of for Benefit of _ Health of Single Patients—Lord Chancellor may direct the Per- son who signed the Order for Admission to furnish him with a Statement of Lunatic’s Property—Form of Admission—Medical Visitation Book—Notice of Discharge of Attendants for Miscon- duct—Special Investigations made at the Direction of Commis- sioners—Regulations for Hospitals to be submitted to the Sec- retary of State—Commissioners may make Regulations for the Government of Licensed Houses—Penalty incurred by Persons obstructing the Execution of Commissioners’ Orders—Bethlehem Hospital subject to this Act—Interpretation of Term—Commis- sioner or Secretary to be at Time of his Appointment a Practising Barrister of Five Years’ standing—Schedules A. 1. Form of Order and Statement for Admission of Private Patients—A. 2. Medical Certificate—B, 1. Order and Statement for Admigsion of Pauper Patient—B. 2. Medical Certificate for Pauper Patient—C. Notice of Admission—Medical Statement—D, Form of Medical Visi- tation Book . . A . ri : , . 361-881 ‘ III. LUNACY ACTS AMENDMENT ACT, 1862, 25 & 26 Vict. c. 111. ‘Interpretation of Terms—Establishment of County Asylums—Pro- vision for Care of Chronic Lunatics—Superannuation of Officers in Asylums—Provision for Superannuation of Matrons—Licensed Houses—Notice of Alteration to be given to Commissioners— Provision as to non-Resident Proprietors—Penalty for Infringing ‘Terms of Licence—Extension of Powers as to Boarders—Provi- _. sion for sending Pauper Lunatics to Asylums—Detention of Lunatics beyond Fourteen Days prohibited except under Special Circumstances—Admission of Chancery Patients into Asylums: no Certificates necessary—Person who signs “ Order for Admis- ‘sion” to have seen Patient within one Month—Persons prohibited from signing Order—Provision respecting Defective Certificates —Transmission of Documents to Commissioners relative to Ad- mission of a Patient—Visitation by Commissioners—Power for Removal of Lunatic from Workhouse to Asylum—Removal of Single Pauper Patients to Asylum—-Statement of Condition of APPENDICES xix Pauper Lunatics transmitted to Guardians—Copies of Official Entries in Asylum Books—Patients permitted to be absent on Trial from Hospitals and Private Houses—Penalty for conniving at Patient’s Eseape—Correspondence of Private Patients—State- ment of Condition of Single Patients—Discharge of Private Patient—Report to Coroner on Death of Single Patients—Defini- tion of Physician, Surgeon, and Apothecary—Schedules A. 1. Form of Licence—B. 1, Quarterly List of Lunatic Paupers. 382-401 Forms of Notices respecting Pauper Lunatics and Lunatics wander- ing at large . . . . . . . . 403-418 InpEx . ; ‘ . : : 5 ; : 419 The Author will be obliged to any of his readers if they will have the kindness to point out any errors into which he may have fallen in preparing this volume for the press, or to forward him any important information relative to the subject matter of this work, which, if used, he will be happy to acknowledge and embody in subsequent editions. Sussex Hovss, Hamuersmiru, W.: November 1873. MANUAL OF LUNACY. CHAPTER I. HISTORY OF LUNACY LEGISLATION, I propose in this chapter briefly to sketch the progress made in lunacy legislation from the earliest period in which we have any record of statutory enactments for the protection of the insane. The recognition of insanity by the ancients is clearly established. Our Classical writers, who lived many years before Christ, frequently allude to the subject. Repeated reference is made in the Bible to persons mentally afflicted. ~The madness of Saul may be mentioned as one of the first instances of mental disease that we possess. David was supposed to have subdued by music his attacks of maniacal fury. David, who reigned from 1055 to 1015 3.c., feigned madness, and in the first book of Samuel (chap. xxi.) we find this simulation alluded to as follows :—‘“ Then said Achish unto his servants, Lo, ye see the man is mad: wherefore then have ye brought him to meP Have I need of madmen, that ye have brought this _fellow to play the madman in my presence? Shall this fellow come into my house ?”’ Notwithstanding the constant allusions to madness B Recognition’ of madness - by the ancients. The madness of Saul, one of the first allu- sions to insanity, David's feigned madness mentioned in the Bible 1055 B.C. First insti- tution for lunatics established in the East, 491. Asylum at Bagdad in the twelfth century. Emperor lexius founded hospitals for the insane in twelfth century. Dealing with property of lunatics under the “ feudal system.” 2 MANUAL OF LUNACY among the ancients, we do not meet with any account in the writings of that period of hospitals appropriated to the insane, or of any legislative enactments for their protection. The first institution for the insane was established in the Hast. In the year 491 one existed at Jerusalem. In the twelfth century, Benjamin of Tudela men- tions there was a large edifice at Bagdad, called “ Dal Almeraphtan” or “ House of Grace.”’ In this building all persons of unsound mind were received in summer, and kept confined in ehains until they recovered. This establishment was visited by the magistrates every month, whose duty was to examine the state of the patients, and to discharge those who had recovered. In the same century, the Emperor Alexius founded hospitals for the insane. Asylums were common among the Moors. About thirty years ago there was at Fez,. the holy city of the empire of Morocco, a Muriston, or Asylum, in which the poor patients were chained, and treated as cruelly as lunatics were in the Timarahane at Constantinople during the sixteenth century. Under the feudal system in this country, when Jands were held under military tenure, subject to military services, when the vassal was rendered incapable of performing such duties, the lord seized upon his rents and profits; this custom applied to all idiots and in-. fants. i The lawless and violent practices of the ancient barons made it reasonable to suppose, that in con- sequence of the spoliation and waste that constantly occurred in the property of lunatics, the Legislature was induced to place them under the immediate protection of the Crown ; but the exact period at which this change was effected is unknown, and we do not even know by what statute the King first acquired this jurisdiction. It appears to have had no existence in the time of John, HISTORY OF LUNACY LEGISLATION 3 as no allusion to any prerogative of this nature can be found in Magna Charta; and Bracton, who wrote in the reign of Henry III., does not mention it. We are informed by Fleta that certain persons called pees Tutores used to have the custody of the lands idiotarum of the : lunatics et stultorwm, and he states that in- consequence of an formerly in abuse of their trust, a statute was made in the reign of tPatores, Edward I., 1272, by which “ the custody of the persons and the inheritances idiotarwm et stultorwm, being such a nativitate, was given to the King, with a reservation to the lord of all his lawful claims for awards, relief, and the like.” This statute is not in print, but in the sub- sequent reign the Act “ De Prerogativa Regis” was passed, the ninth chapter of which enacts that “the King shall have the custody of the lands of natural fools, taking the profits of them without waste or destruction, and shall find them with necessaries, of whose fee soever the lands be so holden; and, after the death of such idiots, he shall render it to the right heirs ; so that such idiots shall not alien, nor their heir be disinherited.” Algo, “ the King shall provide, when any/that before- time hath had his wit and memory happen to fail of his wit, as there are many per lucida intervalla, that their lands and tenements shall be safely kept without waste and destruction, and that they and their household shall be maintained comfortably with the profits of the same ; and the residue shall be kept for their use, to be delivered unto them when they come to be of right mind.” By this it appears, that the duty of protecting all’ The King a ee " ‘ originally mentally afflicted devolved originally upon the King in considered e his capacity as parens-patrie. protector of P y P P Tunatics We perceive by this brief sketch that the object o the Legislature was to protect the person and property of lunatics, little if any attention being given to their /tunatics . » | subjected to medical or moral treatment. We have abundant evi- Sriditicsin ‘ th dence, that before asylums were founded, lunatics were {peo * By2 Anecdote showing the inhuman feeling entertained towards lunatics in Insanity in the reign of Elizabeth, 4 MANUAL OF LUNACY treated. with great cruelty. They were frequently cast into prison, and their delusions, from a misconception of their nature, punished with death. The prejudice against, or rather the inhuman feeling entertained towards persons mentally afflicted, is curi- ously illustrated by an anecdote mentioned in the His- tory of the Royal Society :— In 1660, when experiments were being made in the “ transfusion of blood,” an account was received by the Society of two experiments made in Paris before the Academy of Sciences, on a youth and on an adult, whose veins were opened and injected with the blood of lambs. The experiment having succeeded so well, the Royal Society became anxious to perform it in England. Sir George Ent suggested, that it would be advisable to perform this operation upon some mad person at Beth- lehem. This proposal having met with the approbation of the Society, Dr. Allen, the medical officer at Beth- lehem, was called upon to produce a lunatic for the ex- periment; he, however, positively refused to grant their request. In Paris, the operation was attempted by M. Denis, but the lunatic during the process died in his arms. Many lunatics in the olden time were burnt for witcheraft, others were confined in d in dens fit only for wild beasts. ‘During the reign of Elizabeth, we read of the insanity of Arthington, Coppenger, and Hacket. Arthington was under the delusion that Coppenger was a prophet of mercy, and that Hacket was king of Europe: these two were to go before him and separate the sheep from the . /goats. Arthington was hanged, drawn, and quartered. We read of another lunatic named Venner, who was under the delusion that all human governments were about to cease, and in consequence of this belief, he pro- claimed our Saviour king in the public streets. He was “HISTORY OF LUNACY LEGISLATION 5 followed by a rabble, who were attacked by the militia. Venner was executed in January, 1660, protesting his belief that Cromwell and Charles II. were Christ’s usurpers.* ‘* Many of these poor creatures had more need to be relieved than chastised; more mete were a preacher to admonish them than a jailer to keep them, and a physician more necessary to helpe them than an exe- cutioner or tormentor to hang and burn them.” + ~ The oldest hospital in Europe for the insane is Beth- — lehem. . In 1247 Simon Fitz-Mary, one of the Sheriffs of London, in consequence of the superstition then exist- ing, was desirous of founding a religious house. By a deed of gift which is still extant, he appropriated all his lands situated in the parish of St Botolph, the spot known as Old Bethlehem, for the foundation of a priory. The prior, brethren, canons, and sisters, for whose maintenance he provided, were distinguished by a star upon their mantle, and were directed to receive and en- tertain the Bishop of St. Mary of Bethlehem, the canons, brothers, and messengers of such order, as often as they came to England. We read nothing more of Bethlehem until 1547, in which year Henry VIIL, in abolishing monasteries, seized upon. it and presented it to the City of Lon- don, with all its revenues, as a residence for lunatics. This was the first asylum established in England; and Lord Ashley, in 1845, previously to introducing into the House of Commons a bill for the protection and care of lunatics, said “that the whole history of the world, until the era of the Reformation, does not afford an instance of a single receptacle assigned to the pro- * “ Biographical History of England,” 1784. -t “Discovery of Witchcraft,” Scot, 1665. 1247, Bethlehem founded ag a priory. 1547. Henry VIII., ‘presents Bethlehem to the City of London, to be used as a hospital for the insane ; the first insti- tution established in Europe. 6 MANUAL OF LUNACY tection and care of these unhappy sufferers, whose malady was looked upon us hardly within the reach or hope of medical aid. If dangerous, they were incarcerated in the common prison ; if of a certain rank in society, they were shut up in their houses, under the care of appropriate guardians : chains, whips, darkness, and solitude were the approved and only remedies.” At that time Bethlehem was situated in a dark and confined neighbourhood, and was quite inadequate for the purpose for which it was intended. In consequence of either the gradual increase of insanity, or from more attention being paid to this disease, it became necessary to build a new and larger hospital for the reception of lunatics. In 1644, during the reign of Charles I., it was pro- posed to enlarge the old building, but the close and confined situation would not allow of the hospital being rendered more commodious. In the reign of Charles IL, April 1675, in consequence of the meagre accommoda- tion for lunatics, the Lord Mayor, Aldermen, and Com- mon Council of the City allotted to the Governors a large piece of ground, situated near London Wall, on the south’ side of the lower quarter of Moorfields. The erection of the new building was completed by ‘July of the following year, at a cost of 17,0007. The hospital afforded accommodation for one hundred and fifty patients. The design of the hospital was taken from the Tuileries in Paris. Rules were framed for the guidance of those who for oe guid- were interested in the welfare and management of the attendants. ‘patients confined therein; one of the rules was :—‘ That “no keeper or servant gheala beat or ill-treat a lunatic, '\ without he considered it absolutely necessary for the better governing of the lunatic,” HISTORY OF LUNACY LEGISLATION 7 In 1734, during the reign of George II., two ad- ditional wings, capable of receiving one hundred patients incurable of each sex, were added.* In consequence of the insufficient accommodation | 1751. St. Luke’ for lunatics in 1751, St. Luke’s Hospital was founded Hospital by voluntary contributions, and Manchester, York, and — other large cities built hospitals for the confinement of the insane. The first legislative enactment for the protection of _ 1744. G First legis- lunatics was made in 1744. The ‘Vagrant—Act—con- lative enact- tained a section dealing with persons “furiously mad, or fone so far mentally disordered as to be dangerous if left at ment of the large.” By this section two justices of the peace were authorised to issue a warrant for the arrest of any lunatic, who was to be locked up in a secure place, and if it was found necessary, he was to be chained and confined in his own parish, and if in possession of any ‘ property, it was to be expended for his maintenance. This clause did not afford any real protection for the insane. In 1763 a Committee was appointed by the House 4,175 of Commons to enquire inte the condition of the insane, sppointed by This Committee confined its investigations to two car. {enquire dinal points. dition. oF Sri = . lunatics, 1st. The manner of admitting patients into houses kept for the reception of lunatics. 2nd. The treatment of them during their confine- ment. The chief witnesses who were called were persons who had been surreptitiously enticed away from their homes by relatives under false pretences and placed in asylums. : The evidence of the witnesses examined before this * In 1814 the hospital was pulled down, and the patients trans- ferred to a new building in St. George’s Fields, which was enlarged in 1838, Evidence given before Committce. Resolution adopted by Committee. 1774. First Lunacy Act. 1773. Mr. Town- shend intro- duces the Bill. 8 MANUAL OF LUNACY Committee proved, beyond all doubt, that there were’ many persons illegally confined under the plea of ‘in- sanity. The treatment to which they were subjected was harsh in the extreme. They were excluded from all intercourse with the outward world, and many of them were cruelly chained. Two keepers of a notorious madhouse stated “ that during the six years they had resided in the asylum they had never admitted a single patient of unsound mind into the house, and that the patients received were drunkards and sane people placed there by their friends and treated like lunatics.” No medical man visited the asylum, and the inmates received no medical treat- ment. Such, then, was the deplorable condition of the insane in 17638, before any legislative measures were proposed by Parliament for the alteration of the law relating to the confinement of persons alleged to be insane. The Committee of the House of Commons, after examining several witnesses, proposed and adopted the following resolution: “That it is the opinion of this Committee that the present state of madhouses requires the interposition of the Legislature.” The subject of the then existing condition of lunacy having been brought conspicuously before the House of Commons, a discussion arose in. the House, but which failed to lead to any immediate results until 1774, in which year was passed the first Act for the regulation of madhouses. On February 1, 1773, Mr. Townshend moved the first reading of the bill for the “better regulation of madhouses.”” He drew the special attention of Parlia- ment to the abuses then existing in these institutions. He said ‘‘that the facts which had come to his immediate: knowledge were such as would awaken the compassion HISTORY OF LUNACY LEGISLATION 9 of the most callous heart,” showing that these unhappy creatures were subjected to barbarous treatment which could not be equalled in any other European State. This motion was seconded by Mr. Mackworth, who stated that “he had written evidence of such character as to shock the most hardened heart. The scenes of distress lie hid in obscure corners, but if gentlemen were once to see them, I am convinced they would not rest_a day until a bill for their relief was passed, and for my part I solemnly protest that I will neither mind time nor trouble, but employ every hour until some relief may be obtained.” On February 11, Mr. Townshend moved that the report which was made by the Committee, upon Feb- ruary 22, 1763, appointed to enquire into the state of the private madhouses in this kingdom, might be read. Leave being given to bring in the bill, Mr. Town- shend, in moving the second reading ‘on April 22,1778, informed the House that he had framed the bill with a view of remedying two evils :— 1st. The incarceration of sane persons in asylums; 9nd. The barbarous treatment of those admitted. He told the House that asylums were under no regu- ‘lations, receiving who and what they pleased; that the inmates were subjected to no inspection, and received no remedial treatment of any sort; and that within seven miles of London eighteen of these madhouses could be found in which sane persons were undoubtedly confined. In his bill he proposed :— 1st. That no person should be received into these institutions without having been first examined by persons nominated by the College of Physicians. 2nd. That the College of Physicians should appoint inspectors to examine into asylums, and personally in- spect the persons confined, once or twice annually. 8rd. That the proprietor of an asylum should be Purport of Mr. Town- shend’s Bill. \ Chief sec- tions in Act. 1813. Mr. Rose’s Lunacy Act rejected. 1814. Attention of 10 MANUAL OF LUNACY compelled to take out a licence from the said College of Physicians. The chief object of this bill was to prevent any one being illegally confined as a person of unsound mind, and to protect the interests of those properly placed under restraint. The bill was then read a second time, and became law on November 20 of that year. It prohibited any person taking care of or receiving more than one lunatic into his house, without a licence. . It enacted that five Fellows of the College of Phy- sicians, elected by the President and Members, should be appointed to act as Commissioners, and authorised to visit asylums and grant licences. No person was to act in this capacity for three consecutive years. An oath was taken by each of these Commissioners not to reveal to the proprietor of the asylum the date of their proposed visit. The Commissioners met annually on the third Wed- nesday in October, for the purpose of granting licences. These licences were made out under the seal of three of the Commissioners, and a specified charge, according ° to the number of patients, was made. ; By this Act, the Commissioners were to examine into the condition of the licensed houses once a year. It was enacted that the Act of 1774 should continue in force for the term of five years. At the expiration of: this time it was deemed advisable to have it renewed for a farther period of seven years, the Act becoming per- petual in the 29th year of the reign of George IIL., 1789. Nothing important in lunacy legislation occurred until 1813. During this year a bill was brought before Parliament for the better regulation of asylums, but in consequence of the opposition the bill received from the House, Mr. Rose, who had proposed the bill, withdrew it. The attention of the House of Commons was again HISTORY OF LUNACY LEGISLATION 11 - drawn to the condition of the insane on April 5, 1814, by Mr. Rose, who narrated to the House some most aggravated cases of persons in these establishments who were of sound mind. ; He mentioned the case of a lady who had been placed in an asylum by her husband, who, upon being asked whether he considered his wife mad, replied, “ Oh, no! but I consider the place a kind of Bridewell.” * Mr. Rose informed the House that, notwithstanding the other Lunacy Acts which had been passed, it was even then the custom to admit patients without pre- viously enquiring into their state of mind. He drew their attention to the extraordinary fact, that ten years had elapsed before the resolution passed by the Com- mittee in 1763 had been adopted, and that the Act passed in 1774 was found to be quite inadequate to pre- vent the evil then existing. After describing to the House the condition of one of these asylums, in which the patients were confined in cells on the ground-floor, nine feet long, the ground wet, and the only furniture consisting of a box which con- tained straw to be used as a bed, he moved for leave to bring in his bill for thé better regulation of private - asylums ;. the chief purport of his bill being to the effect, that the magistrates in the different counties should periodically visit the private madhouses within their respective counties and report on the subject. This bill passed the House of Commons, but was ultimately rejected by the House of Lords. The rejec- tion led to a motion being passed for the appointment of * Edward VI, founded a hospital in the vicinity of St. Bride’s well, one of the holy wells of London, situated near St. Bride’s Church in Fleet Street. This hospital was afterwards converted into a receptacle for disorderly people. The name of “ Bridewell” is constantly given to houses of correction situated in different parts of the-country, in consequence of the hospital having been the first institution used for that purpose. House of Commons drawn to the condition of the insane. 1814. Attention of House of Commons drawn-to the condition of asylums. 1814, Mr. Rose’s Act passes Commons, but is re- jected by Lords; a Committee is ordered to enquire into the con- dition of the insane. 1815. Report of Committee brought con- spicuously before House of Commons, Conclusions arrived at from con- sideration of report. 1815. Report ordered to be printed. 1816. Committee of House again sit. 12 MANUAL OF LUNACY a Committee of the House of Commons to enquire into the management of lunatic asylums in the United Kingdom. The Committee, notwithstanding they were appointed in 1814, did not commence the examination of witnesses until a year afterwards. The report of this Committee was brought up before the House by Mr. Rose on July 11, 1815, and contained some most startling and heartrending details. The chief conclusions arrived at were :— 1st. The indisputable necessity for legislative inter- ference. 2nd. That the treatment of lunatics was worse than “the treatment of prisoners in gaols. 8rd. That the authorities who were deputed to take care of these unhappy creatures were quite incompetent to do so, in consequence of which, barbarous treatment was frequently resorted to. ; 4th. The Committee had reason to believe that many lunatics would ultimately recover if the legislative mea- sures were sufficiently stringent, so as to guarantee their proper surveillance and treatment. To further this end, and as proof of this last statement, the report contained an account of a poor insane woman, who, having for some time been chained to the floor in a parish work- house, disturbed all the other inmates by her cries, and who, on being removed to a proper place of confine- ment, was by judicious treatment cured in the space of five months. The report of the Committee having been read before the House, it was ordered to be printed. This Committee again sat in 1816, and it was found necessary to make a more searching enquiry into the condition of the insane. Most painful disclosures were revealed, and the Committee decided that immediate legislative interference was requisite. In consequence of this decision of the Committee, HISTORY OF LUNACY LEGISLATION 13 legislative measures were from time to time introduced, but they were all rejected by the House, and it was not till 1828 that any bill was passed relating to the care of the insane. It is not proposed to give any abstract of the various bills brought before Parliament between 1816 and 1828, as they were all rejected. In 1828 Mr. R. Gordon brought in his bill to amend the law for the regulation of lunatic asylums. He called the attention of the House to the report issued by the Committee which had sat during the previous session. The result of the enquiry was such as to fully justify him in bringing in his bill. He drew the attention of Members to the fact that, under the existing defective state of the law, there was nothing to interfere with the incarceration in an asylum of any person possessing. a large income, by any one of his friends, relatives, or ac- g' 2 ? ! . . . 2 Fs quaintances, who from interested motives desired to place him in confinement as a lunatic. He said that the only provision of the law against the illegal confinement of an individual under the plea of insanity was that the keeper of a lunatic asylum could not receive any one as a lunatic without a certificate signed by a physician, surgeon, or apothecary ; and he drew the especial atten- tion of the House to the derivation of the term “ apothe- cary,” “a seller of drugs,” so that any dealer in drugs had the privilege granted to him of signing a certi- ficate and so sending one of his fellow-creatures to an asylum; and not only the apothecary, but the boy in the shop, who was his apprentice, could do the same as soon as his indentures were terminated. Thus the poor ignorant apothecary, possessing no diploma, and, perhaps, never having entered a hospital, might send to an asylum a person perhaps labouring under the delirium of fever, mistaking it for the delirium of in- sanity. . 1828. Lunacy Act of Mr. Gor- don passes both Lords and Com- mons. 1828, Mr. Gordon introduces his bill. — 1828, Lord Ashley seconds the bill. rc 1828. Chief clauses in Act, 14 MANUAL OF LUNACY Mr. Gordon told the House that it was the business of the Legislature to prevent, as far as possible, the illegal confinement of persons, and all the witnesses examined before the Committee had agreed that some new enact. ments were necessary to regulate the mode of granting certificates. Passing on to consider the deficiencies in the existing law, he stated to the House that the only regulation in the law for the protection of lunatics had been violated, in consequence of the five Commissioners appointed by the College of Physicians having neglected their duties to visit asylums and patients annually, and: report the results of such visits to the College. In con- clusion, he told the House “that in Holland, France; # Italy, and even in Spain, there were establishments ex- isting for the reception of lunatics, which, to those of this country who had visited them, were the subject of envy and admiration,” The motion was seconded by Lord Ashley, and leave was given to bring in the bill. The chief difference ex- isting between this Act and the one passed in 1774, had - special reference to the granting of medical certificates. « It was herein ordered that every certificate for a patient’s, admission was to be signed by two medical men, who had to separately visit and examine the patient, and to state that he was a fit person to be confined in an asylum: The medical men who signed the certificate must have no interest in the asylum, or be connected with it in any way. The Act enabled the Commissioners (fifteen in num- ber, and appointed by Government) to revoke or refuse any licence they might think proper. The person who signed the order for the patient’s admission was obliged to visit the patient at least once every six months, and if prevented from doing so, he was to delegate some one to visit in his place. The Commissioners had power, if they thought HISTORY OF LUNACY LEGISLATION 15 proper, to order the liberation of any person from the asylum. Every asylum was to be visited at least four times a year by three of the Commissioners. ° Notice of discharge or death of a patient was to be given to the Commissioners within three days from the time of such discharge or death. Notice of the patient’s admission had to be sent to the Commissioners. within seven days from the date of such admission. All asylums containing more than one hundred patients were required to have a resident medical officer ; if containing a less number of patients, it was requisite for a medical man to visit the asylum three times during the week. No single patient could be placed under care or treatment without first obtaining two medical certi- ficates and an order, except in the case of a relative, and any person keeping an asylum without a licence was liable to an action for misdemeanour. We thus see, that before the passing of this Act ia\ 1828, there was no power to punish any infraction of the law, or to refuse, or revoke a licence. / The medical certificate was signed in a very loose way, and one only required, and this frequently signed by an uneducated person, or by the superintendent of the asyluam—who was not prohibited from signing in his medical capacity—and under whose care the patient was to be confined. Licensed honses were only required to be visited once a year, and the proprietor had no power to dis- charge any person who might have recovered, and no plans of houses were requisite’ previously to the licence being granted. “No return of single patients was made, and no medical visitation necessary. 1833. Amendment Act, chief alterations, 1845. Lord Ash- ley’s Lunacy Act, the Act now in force. 16 MANUAL OF LUNACY This Act was amended in 1838 ; the chief alterations were. the appointment of Commissioners by the Lord Chancellor, with a much wider jurisdiction, called the “‘ Metropolitan Commissioners,’’ who were to hold quar- terly meetings for the purpose of granting licences. Nothing important occurred in lunacy legislation until 1845, in which year Lord Ashley brought in his celebrated Lunacy Act. This bill was introduced in consequence of an elaborate report presented to the Lord Chancellor by the Commissioners in Lunacy in 1844, giving the result of their enquiries as to the condition of the insane in England and Wales. This report plainly pointed out the evils then existing in consequence of an insufficient accommodation for pauper lunatics, and directed attention to the evil prac- tices and injurious treatment of patients confined in licensed houses. The report concluded by recommend- _ Ing various suggestions, twenty-five in number, for the Lord Ash- ley’s speech in intro- ducing his bill. amendment of the law. Lord Ashley, towards the close of the year 1844, brought this report before Parliament, and, in order to show the condition of lunacy even as late as 1844, I will quote the last few lines from the speech of Lord maiiey in introducing his bill. “The House possesses the means of applying a real and a speedy remedy. These unhappy persons are out~ casts from all the.social and domestic affections of pri- vate life—nay more, from all its cares and duties, and have no refuge but in the law. You can prevent by the agency you shall appoint, as you have in many instances prevented, the recurrence of frightful cruelties ; you can soothe the days of the incurable, and mestoea many sufferers to health and usefulness; for we must not run away with the notion that even iva hopelessly mad are dead to all capacity of intellectual or moral exertion. Quite the reverse, their feelings too are painfully active. HISTORY OF LUNACY LEGISLATION 17 T have seen them writhe under supposed contempt, while a word of kindness and respect would kindle their whole countenance into an expression of joy. Their condition appeals to our highest sympathies, ‘Majestic in ruin,’ For though there may be in the order of a merciful Providence some compensating dispensation which abates within the horrors manifested without, we must judge alone by what we see; and I trust, therefore, that I shall stand excused, though I have consumed so much of your valuable time, when you call to mind that the motion is made on behalf of the most helpless, if not the most afflicted portion of the human race.” Lord Ashley succeeded in passing his bill in 1845. It contained 114: sections. The principal Act now in force, with slight amend- ments in those of 1853 and 1862, is that introduced by Lord Ashley in 1845. It is a cause for congratulation that we now have so perfect a law for the protection of lunatics. I speak with some knowledge of this subject, as I have carefully watched its working, in all its details, for some years. Any infringement of it meets with the immediate atten- tion of the Commissioners, who do all in their power to enforce its rigorous fulfilment. A debt of gratitude is due to these gentlemen, who spare neither time nor trouble in promoting the interests of the insane. The general impression appears to have been, that if the Commissioners appointed under tle Act of 1828 had faithfully discharged their duty there would not have been any justification for the merited rebuke which Lord Ashley administered to them when introducing his bill. T have carefully avoided entering into minute details con- cerning the barbarous treatment to which lunatics were formerly subjected. Had I been desirous of revealing c 1853-1862. Amendment Act. Com parison between the treatment of lunatics pre- vious to and at the time of Lunacy Act 1845, 18 MANUAL OF LUNACY startling and well-authenticated facts, I should have had but little difficulty in awakening a thrill of horror in many an apathetic heart by the narration of the in- human treatment and unnecessary cruelty to which lunatics were exposed before the Legislature took up their cause. The insane are no longer treated like wild beasts. Our asylums no. longer resemble the Spanish Inquisi. tion, or the hold of a slave ship; the inmates of these institutions are not now exposed to the painful cut of the whip, or chained like felons to the floor of some pestilential dungeon, uncared for, forgotten, there left to drag their miserable life away until death put an end to their frightful sufferings ; and, while there, exhi. bited to the eager inspection of those desiring to satisfy. their morbid curiosity. J Gratitude and immortal honour must be given. to those who exposed and laid bare these frightful atrocities. PRESENT STATE OF LUNACY IN ENGLAND AND WaLrs 19 CHAPTER II. PRESENT STATE OF LUNACY IN ENGLAND AND WALES. Tur Annual Report of the Commissioners in Lunacy is always looked forward to with interest by all en- gaged in the special study of mental disease, inasmuch as it places before us an official and authentic account of the existing state of lunacy and lunatic asylums through- out England and Wales, and records the history of their progressive improvement under the suggestions which the Commissioners from time to time find it expedient to make. . . The last report of the Commissioners in Lunacy, July 1872, presents a variety of very interesting and valuable information on the present state and statistics of insanity throughout England and Wales, and contains much matter for reflection, both in a moral and social aspect. It is shown in the report that on January 1, 1872, there were 58,640 insane persons in England and Wales. This number includes both pauper and private patients. On January 1 of the previous year, the number recorded was 56,755, a difference of 1,885 between the two years. Besides the number of persons of unsound mind returned on January 1, 1872, there are 170 lunatics ‘found so by inquisition, and residing in charge of their Committees elsewhere than in asylums, hospitals, and. licensed houses. *o2 Cormmis- sioners’ Report, 1872.. 58,640 insane persons on Jan. 1, 1872,. in England and Wales, being an inerease of 1,885 on the- previous year. 20 MANUAL OF LUNACY _ The table below shows the classification and distribu- tion of the patients. Classifica- tion and 5 Total distribu. | Private Pauper tion of aero | wlnjojmf)/ rnin i_ Mf] ep | In County and Borough Asy- ; i lums~-. 138 | 167 | 305 | 13,495 | 15,841 | 29,336 | 13,633 | 16,008 | 29,641 In Registered Hospitals ./1,104 | 998 | 2,102 197 179 376 | 1,301) 1,177] 2,478), In_ Licensed Houses . - | 1,602 | 1,477 |3,079 379 715 | 1,094] 1,981] 2,192] 4,173 In Naval and Military Hos- pitals, and Royal India Asylum -| 880 15 | 395 —_— _— _ 380 15 395 In State Crimi- ' nal Asylum .} 290 51] 341 116 32 148 406 83 489 Private Single " Patients -| 168] 252]; 420]; — _ _ 168 252 420 In Workhouses| — -—]T=- 5,878 | 7,730 | 13,608 | 5,878 | 7,780 | 13,608 Oat-door Pan- i pers . 7 —— _ 3,071} 4,365 | 7,436] 38,071) 4,365 | 7,436}° Total. . | 8,682 | 2,960 | 6,642 | 23,186 | 28,862 51,998 26,818 | 31,822 | 58,640 Probability of Recovery. Probability Out of the 29,641 patients confined in county and of recovel very ually, borough asylums, 2,635 only are deemed curable. Out of the 2,478 patients confined in registered hospitals the number deemed curable is 413. Of 4,173 cases confined in metropolitan and pro- vincial licensed houses the number returned as curable is 527, All patients maintained in the various State asylums are included among those returned as belonging to the private class, not being chargeable to parishes, unions, counties, or eorevehe with the exception of the 148 pauper patients who are confined in Broadmoor Criminal Asylum. No reliable statistics of insanity were published until PRESENT STATE OF LUNACY IN ENGLAND AND WALES 21 1844, and: upon referring to the statistical table of the Commissioners published in that year, we find that the number of persons of unsound mind was 20,611. On January 1, 1861, out of a population of 20,119,314 there were 38,058 insane persons, making a ratio of 1-91 in every 1,000 of the population, and on January 1, 1871, out of a population of 22,704,108 there were 56, 755 insane people, making the ratio of 2°49 in every 1,000 of the population. We see by this that the population, between the years 1861 and 1871, has increased to the extent of 1,415,206, but there are 18,697 more lunatics residing in England and Wales in the year 1871 than in the year 1861, and the ratio per thousand to the population is double, proving a decided increase of insanity beyond that of the increase of the population. I give a table showing the number of patients ad- mitted, discharged, or died, between the years 1859 and 1870. From this it is seen that the number of patients ad- mitted into asylums every year is greatly in excess of the number who are discharged. So long as this is the case, the number of insane persons on the Com- ‘missioners’ register must gradually and progressively increase. First reliable statistics of insanity - published in 1844. Insanity on the increase. Statistical table of ad- missions, discharges, and deaths between the years 1859 and 1870,* Institutions for the in- sane in England and Wales, 180. New county asylums opened during the year 1871. Extra ac- commoda- tion for patients required in Middlesex and Surrey, 22 MANUAL OF LUNACY Dis. | Dis. Total | Years | Admissions a ae Deaths foes a sitiatien covered | covered Deaths 1859 9,810 | 3,270 | 2,850 | 2,332 8,452 858 1860 9,512 | 2,954 | 2,671 | 2,757 8,382 | 1,130 1861 9,329 | 3,182 | 2,110 | 2,657 7,949 | 1,880 1862 9,078 | 3,842 | 1,963 | 2,637 7,942 | 1,036 1863 8,914 | 3,150 | 1,958 | 2,747 7,855 | 1,059 1864 9,473 | 3,256 | 1,950 | 3,174 8,380 | 1,093 1865 10,424 | 3,290 | 2,615 | 3,161 8,966 | 1,458 1866 10,051 | 3,489 | 2,229 | 3,337 9,005 | 1,046 1867 10,631 | 3,581 | 2,327 | 3,377 9,285 | 1,346 1868 11,213 | 3,707 | 2,617 | 3,867 | ° 9,691 | 1,582 1869 11,194 | 3,801 | 2,804°| 3,825 9,930 | 1,264 1870 11,620 | 3,968 | 2,853 | 3,805 10,626 | 1,994 Totals . | 120,749 | 40,940 | 28,347 | 37,176 | 106,463 | 15,186 There are at present existing in England and Wales 180 asylums, hospitals, and licensed houses for the reception of persons of unsound mind, and all subject to statutory and other visitation by the Com- missioners. Of this number 54 are county and borough asylums, 16 registered hospitals, 4 State asylums, 41 metropolitan licensed houses, 65 provincial licensed houses. During 1871 three large county asylums. were opened—at Hereford for the county and city of Here- ford, Beverley for the East Riding of Yorkshire; and one at Macclesfield for the county of Chester. ; The Commissioners, in their report, draw attention to the fact that extra accommodation for lunatics is required in Middlesex. It was decided at the Court of Quarter Sessions, held in November 1871, to appoint a committee of eighteen justices to negotiate for the purchase of land, and procure plans and estimate of cost for the erection of a third county asylum in Middlesex. * Dr. Maudsley’s Paper on Statistics of Insanity, “British Medical Journal,” January 20, 1872, PRESENT STATE OF LUNACY IN ENGLAND AND WALES 23 Additional accommodation for lunatics is also required in Surrey to prevent the overcrowding of asylums, as is at present the case. The reports made by the Commissioners upon the occasion of their statutory visits to the county asylums of England and Wales, now 54 in number, were on the whole very favourable. Various alterations and additions have been made in the county and borough asylums. The weekly cost per head of patients confined in county and borough asylums averaged 9s. 84d. In the previous year the average cost per head was 9s. 54d., whereas in 1858 the average weekly cost for pauper lunatics, including maintenance and clothing, was at the rate of 6s. 8d. per head. The Commissioners during 1871 visited 219 work- houses, and in all 9,738 patients, showing an increase of 2,043 upon the number seen the previous year; the reports were generally favourable. The number of metropolitan private licensed houses amounts to 41; the number of provincial licensed houses to 66. _ Most of these establishments possess every accom- ‘modation and convenience which comfort and even luxury can require, and in these institutions the patients are treated kindly and judiciously. These remarks apply not only to houses which are situated in the metropolitan district, but also to the provincial ones, and it is satisfactory to be able to quote as follows from the last Commissioners’ report, in their remarks “upon the metropolitan licensed houses : — “ Happily there has not been any occurrence in any of the houses requiring special interference or censure of the Board.” * A list of metropolitan and provincial asylums will be found at the end of the chapter relating to the admission of “ private patients” into asylums. Average weekly cost for patients confined in county asylums is 9s. 83d. per patient. Private asylums. * MANUAL OF LUNACY 24 we usanvg auvAlud Pas SPT oe ott 982 99 019 3 = ss * TH0L e _ = a oa "map 1ojoodsuy Land « 5 3 90% 908 908 (sx oe A nar} | wIomex, ‘twadsoH Tan TesoH MLOFIOKN SIL = = — | sit s1 sol | * OMSHUO "NLC | * | wnssy onvuny wpa yedoy | * — x0S0[PPH ob = _ es ob _ GL ° Hosoauig “EA | * = uoduruygnog ‘Aoqqy Aeon | * = °° squBT 68P SFL ee 9IT Tre 19 063 «| * * e8uBIO "A ‘tq | Jooupuorg ‘Mn[AsY peuTMIQoyIg | * + syIOg s1v% | o2e 6LT 161 z0r'e | 866 wrt |” = * = & * yeqOL, 68 = = oa 68 18 9 ‘ * Buoy ria | * * t HIOX “uomeyouL |; * bi 98T 6h 9% ¥ 281 1g 08 * 7 WBypeaN ‘wl “AC | wrvmoog TeniooE, alee MOK }* * HIOX 6Eg = = — 68g GLT 098 TUVAIBID “AD IC {« “poomsyreyy “sq0rpT A0z Lahey f rs 9¥G > is = OF 191 ¥6 "SUVA “HAL IC | PA MyequUT ‘Teydsoy WoysTYIeg |* + foaming * prop) PET _ = - PEL 99 89 * mosmMor “a "Lf Id {ams Tou ‘TH 1040p ‘ouusuy } ° * proyeas O19 10y woRnag Hear aTaea TOO 5 2 Te V ig = — — | ou 8% 6 | Cuamg) uorry seumoyy, {aoysuypvor untssy aos | * + propo ‘ ee = 7 e 6 iis ureysujON ‘eofddop ogy, aj <8 69 e9 «| sae Ig ow a “as 3c | { canptsy onvuny “arugauioy } eon wr | ere | tor | sor | ut | se 1g | + (woaBng) sopdug
SL 8b 9% (aoeBing) UosqrD "WO | * —* YOHMION “leqidson Toyjog | * + 3LOFIONT
zs = _ ad zsI 88 ¥P Josum “1d | * 9e0u8 PIO ‘Tedsoy som 9g | -* —-Xesa|PPEAL
bh = = - oh 98 18 (uooBmg) USeM ‘Ca ]* | TeydsoH ovuny ajooury | + = + upooury
~ a oo «eta 3 * qoysvouvry ee
BL L L 19 19 — | Uaomepquyg a “p “za ores ~ wy sey eary ruber “
‘ed * —* o[peeyd ‘Tey aw
ort = | = | = | om fee | ae | tmetneomom i041, camer gates ae ane t af
OF _ _ —_ OF 61 1% (moeding) TemAo03g *f¢ | * * poqidsoy o1qvun'y toodaeayy | * Joqsoue'y
LL _— _ _— LL 68 88 . * poom ‘eV ‘ad | * Teyseono[ ‘esnoyH poomureg | * Jeysaonopy
LL 1 t - 9L 6g 1g ‘8 oT Ed |" * — teyoxg ‘osuoH{ proyuom | * —* uoAa.
TH0L | “a ‘WN | reoL | ow WW
qratg
a 3181 BLST
uo *{ Avenuve uo “{ Arenuve uo aS Teqydsoxy Aqunog
soyeuny) Buyupeuer squoyneg Sule squeneg Tuorpony
THIOL
sunplisy lange puv ‘oanar ‘ayozg puo ‘spojdsupp pasopsiboye
25
E OF LUNACY IN ENGLAND AND WALES
PRESENT STAT
998° | OF9'es/ SPL | Tre |ossr9| Los‘9 | oep‘z | oz» |soo'et} gee | 1p | sos't | 89 |{ exs't | gue | cots [ges‘ez| coe leet
GPO | seu9g| OIL | PPE | G8T‘OS] OTT'9 | Tee's | BEE | TOTiZT} Fee | $29 | ESHT | 826 | EraT | GE | ge0'% |Zeg'Rs| Lez |TLET
9eS'T | Seine] SOT | 798 G2E'8P| 96'S | 980'L | 99e | BcEtIly 86T 9L | SLFL | FOL | 999'T | OOF | 69E'T | TZL'LZ| |Ggs |OLST
LLUZ | LLI99 [ ene, 968°9F| 0289 | L86°9 } FE | I8IIL}] 606 899 | 19M | 020'T | 299°r | eIh | eget | Z¥9'9s| gze |698T
Fier oo0'ts 9h 918'F%| 869°9 | 6289 | PLZ | PR9‘OL] SSL | GOP | Ges't | I6s | gee‘r | SIF | eog‘t | T9F‘ss| Iz |s08T
88P°L | 980°67 iad Sv6°CF| SOL | 89°9 | E2S | LOG'OL] OGL | 988 | OSo'T | HIG | oge'E | PE | PERL |FLE'DZ] OTe [LIST
869°T | 87927 Tap SPS'TH| 6L9'9 | 08G'9 | Les [E166 | LT | FOS | .L09°T | 268 | seaL | O08 | oes‘t | FIFE] Gzz j998T
SST‘T | 096:9% 608 9100 | gog'e | zec'9 | 21s |oeyie | 921 | sah | 699‘L | O28 | ser‘ | 98 | ste‘T | 220°%%| soz eer
LLO'T | S6L 97 $6 | OGT'GE| OTG'S | Trs‘9 | GSE | OTL.6 | 921 Shr | Gg9°L | r8 | GzFL | 8h | OsZ'L | 008TS| Tes POST
686°1 | SILeh| * 19 28} L0G" | COF‘9 | EST | 80s | SPL | Zee | goz‘T | 928 | BPrT | 908 | 2eL‘T | PIg‘0s| Ges [e98T
BBV I 6ZL Tr] * + 7 je0zice! Osre | zeI'9 | 9FL | so9's | BOL | G09 | 9c9°L | 969 | zerE | 29% | cez‘E |2se'6L| 29 |Z98T
6891) Lp968) * ° * | 18ere} o9a'g | STT'9 | st |ers's | Pst |, Ste | gear | E49 | oge'E | 8g% | est |oge'st| ziz |T98I
96Z'T} B20'8s| * * + | e66eE] soO's | Ogee | ATE |6Ies | Let | og 909°T | 209. | ape‘t | s8c GI9'T | 60621] 22 [098T
Bau 98 . [S828] 086% | BEz'9 | BEL | eG, | FOL | FE6 | LhS'T | FOC‘T | LEV‘T | 91S | GEOL j2TO'eL] 226 [6sst
‘ ——
_ _- tednegjoqeatig |zodnegiaqeatrg |redueglayeatrg|szadneg|eyeartg|redneg| aqeatig\zodnegloyeaprg reduvgieyearg
> Q on) lanl 4 '
e| g Slee g
zg] 6 é |BES z
2 4 a | Bes sesno sosn a
M 5 umnssy 197130 10 Roilepe EL OH sumnys Ss
8 gE TECTED Teqoz, = soageoy ual & be kB Goon | womens steqrdsor, qauowg poe 5
g Jooupeoig Ul _ | Surprsey i ge al Ter i ik e403 cone parews}3eu UL] “gamog ut | &
8 | * laws 7
#8
2
‘amonqous ZL-EGRT. sueq oy} fo youve up Ruwnune yey oyg UO “punzy
punosug fo suosiag pun ‘soupy ‘soyouny yo fo uoynginnag pwo soqunyt yx buymoyg—-{ wavy,
, IBLBT Wodoy sacuorssimu0|D oy} Woy UEXey ore so[quy, SuysoroqUt A104 SULMOTIOJ 90144 OTL,
26
MANUAL OF LUNACY
Taste Il—The Ratio per 1,000 of the Total Number of
Lunatics, Idiots, and Persons of Unsound Mind, to the
Population, im each year from 1859-1872, both im-
cluswe.
Total Number Ratio
Year Population of anoles, per 1,000 to the
Pa January 1 Population
1859 19,686,701 36,762 1°86 :
1860 19,902,713 38,058 1:91
1861 20,119,314 39,647 1:97
1862 20,336,467 41,129 202 -
1863 20,554,187 43,118 2°09
1864 20,772,308 44,795 2°15
1865 20,990,946 45,950 2°18
1866 21,210,020 47,648 2-24
1867 21,429,508 49,086 2°29
1868 21,649,377 51,000 2°35
1869 21,869,607 53,177 2:43
1870 22,090,163 54,713 247
1871 22,704,108 56,755 2°49
1872 28,074,600 58,640 2°54
In the above Table the population for each year has
been taken from the Annual Report of the Registrar-
General, and is applicable to the middle of the year.
27
PRESENT STATE OF LUNACY IN ENGLAND AND WALES
40-9 29.8 89-2 8L-0T 9¢.g¢ 69-2 TPB $8-01 €8-2 €8-0T * sosCIOAV
86.9 9L-6 86-9 16-6 29. LP-L 60-8 TL-OL 99-8 €3-01 IL81
PSL 6L-0L 16-9 87-6 98-¢ SEL 8F-8 18-01 PEL 6@-01 OL8T
GPL 9-0T 98-L 69-6 19-9 G16 9L-8 9LIL 86-8 SL-0L 6981
06-9 16-6 e8-L €L-6 69-9 GGL 66-L SLOT Sob 8L-6 8981
TLG 80- 96-8 SLIT 88.9 19.8 86-8 99-01 06-2 66-0L L981
98-9 GL-6 SL-6 19-81" 98-9 L6-L 87-8 9L-0L IL-8 6S-01 998T
TE8-G S6-2 91-8 TS-IL 96-9 66-2 97-8 6-01 68-2 GP-0L - S981
€8-¢ LVL S6-L 16-0 00-9 68-9 03-6 €L-11 98-8 88-0 POST
&P-¢ Thk 96-9 9-8 £6-¢ £6-2 81-8 GP-0L PSL 18-6 e981
60-G IL-2 F8-L 80-1 9¢.9 I9-L SOL , 9D0T PPL LLG 6981
£0-9 BL-9 BE-L . O0T 96.9 88-2 69-8 SOIT PLL $8.01 T98T
&6-¢ 99-8 OL-L F0-11 Lo.5 oF-9 G1-6 9T-8T 96-8 82-1 098T
96-9 09-2 BBL TROT 19-F 29-9 OL ~ $@-0T ° BOL 06-6 6981
quouyvely | quepisey | qUeuyveryT, | QuepIsey | JUeWZVeT], | yuepIsey | qUeMyweTT, | YUepIsey | yueUyeery, | JUOpIsey
zepun qaquin yf qepun Jaquin yy xepun zaquim xt Jepun qaqa jy yepun =| sJequmyy
qaqum jy oseDAy Jaquin NT aseI0Ay sequin Ny esuieay equ Ty osBIaA Vy qTequM AT oseI0AV
T8301, 04} Jo/ATreq ogy JoOHTVIOT, O49 JOlATeG ou JOlreqoy, yr JO|ATreq O49 JO|TBIOT, ouy JO|ATeC ou Jo|TuIOT, O49 Jo|ANeq omy JO
O0T 04 OOT 9} OOT 09 a Ot) OOT 4 O0T °F O0T 0% OOT 9} OOT OF
sqqeeq jo | sqyeaq Jo | sya JO | syyvaq JO | syyweq JO | SuQBEeq JO} syqved JO | SYyVE JO | sug¥eC JO | SyweC JO ava
qaquin yt zaqum yxy qoquInyy qaquinyy qaqum}yT TOQUIN YT qaquin yy Toquan Ty qaquin yy qequmyy | -
sesnOE, pasuaoyry SOSTOYT PESTAOLT = a sumpssy eae : ie
yeroulaerg usyqodoyeyT STEHCSOH Pereys}ooy ysno10g pus Ayun0g ae moRaae S¥
“wwek yone Lof ‘quaUAveL], LAPUN LAQUNAT 7010], 2Y7 07 pwo *
uaprsay woqungy obvicay hyo oy) 04 syzvoq fo woysodorg oy; uoyrsodmanl uz Buymoyg— TIT sav,
Lunacy Act
1845,
Masters in
Lunacy.
Oath taken
by a Master
in Lunacy.
Masters in‘
Lunacy
appointed
by Lord
Chancellor,
Commis-
sioners in
Lunacy.
28 MANUAL OF LUNACY
CHAPTER III.
EPITOME OF THE LUNACY ACT.
On the Law relating to Private Patients.
Tur following is an epitome of the first part of the
Lunacy Act, relating to the Masters and Commissioners
in Imnacy and the granting of licences.
Inthe succeeding chapter I propose to refer to that
part of the Act principally relating to the management of
asylums. ;
The Lunacy Act 1845 repeals 2 and 3 William IV.
c. 22; Land 2 Vict. c. 73; 5 Vict. c. 4; 5 and 6 Vict.
c. 87.
Masters in Lunacy.
The Masters in Lunacy are twoin number. They
act as judges in all proceedings under the writ “de
lumatico imquirendo,” ‘The present Masters are—Francis
Barlow, Esq., and Samuel Warren, Hsq., F.R.S., D.C.L.
Oxon. The salary is 2,0001. per annum exclusive of tra-
velling expenses.
Before acting officially, an oath is required to be
taken.
‘ The Masters are appointed by the Lord Chancellor,
and they must be barristers of ten years’ standing, or
serjeants-at-law.
Commissioners in Lunacy.
Six gentlemen are appointed to act as visiting Com-
missioners in Lunacy ; of this number, three are medical
EPITOME OF THE LUNACY ACT 29
men and three are barristers. The three Medical Com-
missioners are—James Wilkes, Esq., F.R.C.S.; John D. |
Cleaton, Esq., M.R.C.S8.; and Robert Nairne, Esq., M.D.
The three Legal Commissioners are— William George
Campbell, Esq.; Charles Palmer Phillips, Esq.; and the
Hon. Greville Howard.
The unpaid and non-visiting Commissioners are—
the Right Honourable the Earl of Shaftesbury (chair-
man); Francis Barlow, Esq.; Hon. Dudley F. Fortes-
cue, M.P.; B. W. Proctor, Esq.; and John Forster, Esq.
The Secretary is Charles Spencer Perceval, Esq.
The office, 19 Whitehall Place, London, 8.W. *
It is their duty to grant licences, visit and regulate
asylums, report to the Lord Chancellor as to the condi-' :
tion of the same, and conduct and manage everything
connected with certified lunatics in England and Wales. '
A report once a year is issued by the Board of Com- Report of
missioners, in which a vast amount of carefully drawn- sioners.
up statistics and useful information relating to lunacy is
published.
This report is ordered to be printed by the House of
Commons, and is directed to the Lord Chancellor.
The salary of a Commissioner in Lunacy is 1,5001. Balary-of
per annum, and no person can’ act as a Commissioner, sioners.
Secretary, or Clerk to the Commissioners, if at that
time, or within a year preceding, he is or has been in-
terested directly of indirectly in any house licensed for
the reception of lunatics, or derives profit from such
reception.
- ‘The Commissioners are prohibited from holding any
other office, or practising in their respective professions.
Before any one can act as Commissioner, he must
have been a physician, surgeon, or barrister of at least
five years’ standing.
The Commissioners have a common seal, which is scalof Com-
attached to all licences, orders, and instruments. ane
Chairman
of Commis-
sioners.
Salary of
Secretary.
Limits of
Commis-
sioners’
jurisdiction.
Licensed
houses
beyond im-
Mediate .
jurisdiction
of Commis-
sioners.
Incapacity
of a visitor
30 MANUAL OF LUNACY
The office of Chairman to the Board of Commis.
sioners is a permanent one; and no physician or bar-.
rister can act as such. No remuneration is attached to it,
The Secretary’s salary is 8001. per annum.
The limits of the immediate jurisdiction of the Com-
missioners comprise the following places :—
The city of London, the city of Westminster, the
county of Middlesex, the borough of Southwark.
The following places in the county of Surrey :—
Barnes, Camberwell (St. Giles), Dulwich, Battersea,
Clapham (Christ Church), Graveney, Bermondsey (St.
Mary Magdalene), Kennington, Brixton, Deptford (St.
Panl’s), Kew Green, Lambeth (St. Mary), Mortlake,
Merton, Newington (St. Mary), Mitcham, Norwood,
Peckham, Roehampton, Stockwell, Putney, Rotherhithe
(St. Mary), Streatham, Wandsworth, Tooting, Wim-
bledon, Walworth.
The following places in the county of Kent :—
Blackheath, Greenwich, Charlton, Lee, Woolwich,
Deptford, Lewisham.
The following places in the county of Essex :—
East Ham, Leytonstone, Plaistow, West Ham, Leyton,
Low Leyton, Walthamstow, Southend.
And every other place (if any) within the distance of.
seven miles from any part of the cities of London and
Westminster, or borough of Southwark.
All houses not within the “ immediate jurisdiction ”
of the Commissioners are visited by persons nominated
at the Michaelmas Quarter Sessions in each year. The
licences for these houses are granted by the Justices at
the Quarter Sessions. These visitors are appointed in
every county or borough.
The visitors consist of three or more justices, who
act.gratuitously, and one (or more) surgeon, physician,
or apothecary, who receives remuneration.
If any of the visitors die, or from any cause become
from acting. unable to officiate, it is lawful for the justices of the
EPITOME OF THE LUNACY ACT 31
county or borough to appoint a visitor to fill up the
vacancy, the appointment being made at the Quarter
Sessions. :
A list of visitors of licensed houses not within the
immediate jurisdiction of the Commissioners is pub-
lished, by the Clerk of the Peace, and a copy sent to the
Commissioners in Lunacy.
The appointment of Clerk to the Visitors is made at
the Quarter Sessions.
The visitors and the clerk take an oath of fidelity and
secrecy, and must not be interested in any licensed
house.
Two of the visitors, one being a medical man, are
required to visit four times during the year all asylums
beyond the immediate jurisdiction of the Commissioners.
And by the amended Act 1862, in addition to these
visits, the asylum must be visited by one or more of the
visitors twice during the year.
The official books required for the visitors’ reports,
are, “the Visitors’ Book,” “‘the Patients’ Book,”’ and “the
Medical Visitation Book.” A copy of these entries must
be sent to the Commissioners and Clerk of the Visitors
within three days from their visitation, and be placed
before the justices when the yearly licence is granted.
In addition to being officially visited, as stated above,
all houses not within the “immediate jurisdiction ”’ of the
Commissioners in Lunacy are supervised by two of the
Commissioners (one being a barrister, and the other a
medical man) twice every year.
The Commissioners in Lunacy make entries in the
official books. A copy of these entries is sent within
three days after such visitation to the Commissioners
and to the Clerk of the Visitors.
Clerk to
Visitors.
Visitation
of asylums
beyond the
immediate
jurisdiction
of Com-
missioners:
Commis-
sioners’
supervision
of asylums
beyond their
immediate
jurisdiction.
Visitation
by Commis-
sioners of
licensed
houses.
Enquiries
made at
Commis-
sioners’
visitation:
Commis-
sioners _
enabled to
visit asy-
lums during
-the night.
Single
patients
must be
under
certificate.
32 MANUAL OF LUNACY
Visitation of Cominissioners.
The Commissioners visit all licensed houses within
their immediate jurisdiction six times a year.
Four of these visits are made conjointly by a medical
and legal Commissioner, and two single visits are made
by a legal Commissioner.
Enquiries made by the Commissioners at the time of their
Visitation.
1st. Number of patients then in the house.
2ndly. Number of patients admitted since their last
visit.
drd. Number of patients discharged or died since
their last visit.
4th. Particulars relating to carriage drives and walks
of the patients.
5th. Number of patients attending Divine Worship.
6th. Particulars relating to the occupations and
amusements of the patients.
7th. Number of patients then under medical treat-
ment.
8th. Particulars relating to restraint and seclusion
made since last visit.
9th. Particulars relating to the visitation of the
patients by their friends.
Night Visitation.
Two or more of the Commissioners may visit any
licensed house or hospital, at any hour of the night they
think proper.
Single Patients in Unlicensed Houses.
No one deriving profit from the care or charge of a
person of unsound mind can receive a patient into his
house without the necessary ‘* order ’’ and “ medical cer-
EPITOME OF THE LUNACY ACT 33
tificates,” as required in the case of patients confined in
asylums.
This does not apply to persons found lunatic by
inquisition, to whom reference is made in the chapter
on Chancery Lunatics.
Two or more Patients.
In the case of two or more persons of unsound mind
‘being received into a house with a view to profit, a spe-
cial licence from the Commissioners is necessary.
Property of Lunatics,
The Commissioners have to report to the Lord Chan-
cellor if the property of the lunatic is not duly protected
or administered.
Visitation of Gaols and Workhouses.
Two or more of the Commissioners are empowered
fo visit all workhouses and gaols in which any lunatic,
or alleged lunatic is confined, and to ascertain if all
the provisions of the law have been carried out, and
make other enquiries they may think proper as to their
management, &c.
Dangerous Lunatics.
No lunatic, if certified to be dangerous, can be re-
moved from any house or hospital, without first obtaining
the consent of the Commissioners and visitors.
Discharge of Patients can be ordered by Commissioners.
The Commissioners have power to discharge any
patient confined in an asylum or licensed house, if
after two visits they consider him to have been im-
properly detained. Seven days must intervene between
these visits. This does not refer to Chancery lunatics
or persons confined by order of the Secretary of State.
D
Licence
required for
more than
one patient.
Commis-
sioners en-
quire into
the property
of patients
not duly
protected.
Discharge of
dangerous
lunatics
prohibited,
except by
consent of
Commis-
sioners.
Commis-
sioners can
order the
discharge of
patients.
Time for
granting
Ticences for
asylums,
Application
for licence.
Application
for renewal
of licence.
Practice of
Commis-
sioners in
granting
licences as
stated in
their 13th
Report,1859.
34 MANUAL OF LUNACY
Incences.
_ . The Commissioners meet at their office, 19 Whitehall
Place, 8.W., on the first Wednesday in the months of
February, May, July, and November, to receive appli-
cations for licences; but they are also empowered to
receive and determine such application at any special
meeting summoned for the purpose.*
Form of Application for Licence.
Application must be made by the person or persons
applying for the licence, fourteen days previous to the
meeting of the Commissioners.
An application for the renewal of the licence must
have attached to it a statement of the number and
names of the patients, male and female, at that time
resident in the asylum.
If the application refers to a house that has not been
previously licensed, it must be accompanied by a plan
of the house drawn upon a scale of not less than one-
eighth of an inch to a foot, number and size of the
rooms, quantity of land attached, &c. The number of
patients for which the licence is required must also be
stated, and whether it is proposed to use the house for
male or female patients, together or separately.
The Commissioners in their thirteenth Report, dated
March 31, 1859, state clearly what course they pursue
in dealing with applications for licences.
I quote from their report :—
“ In reference to our practice of granting licences, it
is not necessary to enumerate the instances in which we
have considered it our duty to refuse them. The Legis-
lature has given us a discretion on the subject; and the
question to be considered by us on receiving such ap-
* Vide Schedule A, 8 and 9 Vict.c. 100, and Schedule A, 25
and 26 Vict. c, 111.
EPITOME OF THE LUNACY ACT 35
plications, appears to be whether or not an additional
house is required for the accommodation of insane
persons, and also whether the qualifications of the
persons applying are such as (under other cireum-
stances) would induce us to grant the licence.
In some districts the number of houses licensed is
already too numerous.
Should it seem advisable to grant a new licence, it
ig our custom to propose the following questions :—
1. State your age, and whether you are married or
single, and whether you propose to reside on the pre-
mises to be licensed.
2. If married, is it proposed that your wife (or
husband) should reside in the house to be licensed, and
take any, and if any, what part in the charge and ma-
nagement of the patients P Have youany children, and
if so, of what age and sex respectively, and is it pro-
posed that they, or any of them should be resident i in
the licensed house ?
8. Are you a medical man? If so, state where you'
received your professional and general education,-what
degree you have received, or examination you have’
passed, and where and for how long you have been en-
gaged in the practice of your profession. If not a:
medical man, state what your profession or occupation
has been. Also state the name and address of the person
who is.to act as the medical visitor and attendant of the
patients.
4. State the nature and amount of your education,
training, and experience with reference to the care and
treatment of the insane, and when, and where, and under
what circumstances obtained.
5. Produce testimonials or other satisfactory evi-
dence as to your skill and experience as a medical prac-
titioner, and asa person fit to be entrusted with the
. D2
Questions
asked by the
Commis-
sioners be-
fore grant-
ing a new
licence.
Licences
granted for
new houses.
36 MANUAL OF LUNACY
charge of the insane; and also as to your possession of
the necessary pecuniary means for enabling you to carry
on and maintain the establishment ina comfortable state.
6. What is the nature and extent of the interest
which you possess in the house and premises proposed
to be licensed ? Have any other persons, and who, by
name and description, any and what interest in the house
and premises jointly with yourself or otherwise, or in the
profits to be derived from the establishment ?
7. What class, and number of patients, and of
which sex do you propose to receive into the house, and
paying what weekly or other rate of board ?”
Should the foregoing be satisfactorily answered, an
inspection of the premises is undertaken, and a report
made by one or more Commissioners as to their general
capabilities for the number and class of patients for
which a licence is desired.
The Board subsequently considers the question, and,
if satisfied, grants the licence, subject, if necessary, to
such stipulations as the case may require.
On granting licences for new houses, or promoting
changes in houses already existing, we endeavour to
secure for the inmates free intercourse within doors, and
a ready access to the open air.
These advantages being often curtailed when patients
of both sexes are placed in dwellings of an ordinary size,
standing in limited grounds or gardens, we have gene-
rally required that the proprietor of such houses should
admit only one sex.
The resnlt of the progressive change thus effected,
by means of the foregoing requisitions and stipulations,
will be made evident by stating that out of the 40
metropolitan houses, only 17 are now licensed for the
admission of both sexes; and in order that the most
competent parties only should be allowed to act as super-
intendents of the insane, we have had it under serious
EPITOME OF THE LUNACY ACT 37
consideration whether it might not be expedient, as a
general rule, to grant mew licences only to medical
men.”
In their fourteenth Report, the Commissioners make
the following additional remarks :—
“Fora statement of our practice in granting licences
for the first time, we take leave to refer your Lordship
to our last report (p. 58), and more especially to the
questions, of which a copy will there be found, required
to be answered by applicants.
' The subject, generally of licences for the reception
of lunatics, and their grant, renewal, and transfer, has
continned during the past year to engage our serious
attention, and the importance of the considerations in-
volved induces us, upon this occasion, shortly to re-
iterate the principles by which we are guided in dealing
with applications.
As respects the metropolitan district, we have prac-
tically come to-the resolution not to add to the number
of licensed houses, unless for special reasons applicable
to the particular case. In the event of a medical man
or other person of high character and qualifications, and
possessing adequate pecuniary resources, applying for a
licence to receive private patients in a suitable house, we
should be disposed to make an exception, but should in
that case, generally, if not invariably, limit the licence
to patients of one sex.
The- licensed houses within our immediate juris-
diction, judging from the actual number of patients
resident therein, appear fully to meet, not merely the
requirements of the special locality (which would be
practice of
Commis-
sioners in
granting a
licence for
14th Report,
1860,
comparatively unimportant, inasmuch as private patients *
are, for the most part, sent to asylums not in the neigh-
bourhood of their homes), but in general the wants of
the community.
We have also to observe, that in consequence of the
Licence
available
for thirteen
months.
Ten shillings
paid for
every patient
in licence.
Licence
when
granted to
two or more
persons.
Asylums
licensed
before pass-
ing the Act
of 1845,
38 MANUAL OF LUNACY
now rapid withdrawal of the pauper patients from the
five large metropolitan houses at present licensed to
receive that class of the insane, extensive provisions will
shortly be made for the accommodation of patients of
the middle and poorer classes, for whom it is hoped that
ultimately adequate means of care and treatment will be
afforded in public hospitals.”
An absolute discretion is vested in the Commission-
ers to grant or withhold the licence applied for, as they
think ft.
Duration of Licence.
A licence is granted for a period of thirteen calendar
months.
Cost of Licence.
The sum of 10s. is paid for every private patient for
which the asylum is licensed.
Residence of Licensed Person in the Asylum.
A licence granted for the first time to any applicant,
after the passing of the Lunacy Act 1845, requires the
person to whom itis granted to reside on the premises.*
If the licence is granted to two or more persons, then
one or all of them are required to reside in the asylum.
This refers to houses licensed for the first time after the
Act of 1845 came into force, and not to houses licensed
prior to that time.
An asylum which was licensed before the Act of
1845 may have a medical superintendent residing in it,
who need not be licensed, but he must be approved of
by the Commissioners in Lunacy.
* 16 and 17 Vict. ¢. 96, s. 2.
EPITOME OF THE LUNACY’ ACT 89
Residence of Medical Officer in Asylums.
It is compulsory for every hospital for the insane to
have a resident medical superintendent.
Every asylum licensed for less than one hundred or
more than fifty patients, is required by Act of Parlia-
ment to be visited daily by a medical man, pe
there is no resident medical officer.
Every asylum licensed for less than fifty patents
(provided such asylum is not kept by, or have a resident
medical officer) must be visited twice during the week
by a physician, surgeon, or apothecary. The Commis-
sioners have power to increase the number of medical
visitations, according to their discretion.
If the house is licensed for less than eleven patients
the Commissioners have power to lessen the number of
medical visits.
Licences may include more than one House.
The Justices or Commissioners, as the case may be,
have power to include in one licence any buildings de-
tached from the principal house, if described in the
notice and plan required to be sent to the office when
application is made for a licence. This is onlydone when
these buildings are not separated from the house by land
not the property of the person applying for the licence.
Death or Incapacity of the Person licensed.
If the person to whom a licence is originally granted
die, or from any cause becomes incapacitated from act-
ing, the licence may be transferred by consent of the
Commissioners to any other person. If two persons are
conjointly licensed, and one of them dies or becomes
incapacitated, the licence is still valid with respect to
the other person licensed.
Residence of
medical
officer in
asylums,
If it contain
morethan
50 patients
and Jess than
If it contain
Tess than 50.
Asylum
licensed for
less than 11
patients.
More than
one house
can be
included in
one licence.
Licence can
be trans-
ferred on
death or
incapacity
of licensee.
Lord Chan-
cellor has
power atthe
request of
Commis-
sioners to
refuse or
revoke any
licence,
40 MANUAL OF LUNACY
Refusal to renew Licence.
The Lord Chancellor may, at the request of the
Commissioners in Lunacy, recall or refuse to grant a
renewal of the licence, and any person keeping such
house after the expiration of two clear months from
the revoking of such licence is guilty of a misdemean-
our. Before the Commissioners revoke the licence,
notice is given to the proprietor of the asylum, and
the fact is published in the “ London Gazette.”
ON THE MANAGEMENT OF ASYLUMS, ETC. 41
CHAPTER IV.
ON THE MANAGEMENT OF ASYLUMS AND LICENSED HOUSES.
On the admission of a patient into an asylum, it is the
duty of the medical superintendent to carefully examine
the order, statement, and medical certificates, with the
view of ascertaining their legal accuracy. No patient
can be received into an asylum and detained there if,
1st. The-order be signed by a person who has not
seen the patient within a month from the time of cer-
tifying.
Qndly. The “‘date of examination” of the patient
stated in the certificate be longer than seven days prior
to the patient’s admission. Facts stated in the certifi-
cates must have been observed on the day of the exami-
nation of the patient,
8rdly. The medical certificates are signed by the
persons who are prohibited by Act of Parliament from
signing.*
Omissions and mistakes are frequently made in the
order, statement, and medical certificates, but these
inaccuracies do not necessarily render them invalid.
After being forwarded to the Commissioners, they are
returned by them for alteration, fourteen days being
allowed to the proprietor of the asylum to obtain the
required amendments.
* Vide 16 and 17 Vict. c. 96, 8. 12.
Duties of
medical
officer on
the admis-
sion of
patients
into an
asylum.
Illegal
grounds for
detaining
patient.
Mistakes
made in the
medical
certificates,
Admission
Book,
Case Book.
Directions
for making
entries in the
Case Book.
42 MANUAL OF LUNACY
‘Admission Book.
The name, &c., of the patient must be entered in
the Admission Book* within two days from the patient’s
reception into the asylum. ;
Case Book.
The medical officer is required by Act of Parliament
to keep a Case Book.
The Commissioners in Lunacy, in their annual report
dated March 20, 1863, issued the following regulations
respecting this :—
Case Book.—Revised Order (8 and 9 Vict. c. 100, s. 60).
“The Commissioners in Lunacy, by virtue of the
power vested in them by the Act of Parliament passed
in the session holden in the 8th and 9th years of the reign
of her present Majesty, intituled ‘ An Act for the Regula-
tion of the Care and Treatment of Lunatics,’ do hereby
order and. direct—
That the medical Case Book, by the said Act directed
to be kept in every licensed house and hospital, shall be
kept in the form hereinafter mentioned, viz. :—
1st. A statement of the name, age, sex, and previous
occupation of the patient, and whether married, single,
or widowed.
2ndly. An accurate description of the external appear-
ance of the patient upon admission ; habit of body and
temperament ; appearance of eyes, expression of counte-
nance, and any peculiarity in form of head; of the
physical state of the vascular and respiratory organs
and of the abdominal viscera, and their respective
functions ; of the state of the pulse, tongue, skin, &c.
8rdly. A description of the phenomena of mental
* Schedule E, 8 and 9 Vict. c. 100.
ON THE MANAGEMENT OF ASYLUMS, ETC. 43
disorder; the manner and period of the attack, with
a minute account of the symptoms, and the changes
produced in the patient’s temper or disposition ; specify-
ing whether the malady displays itself by any and what
illusions, or irrational conduct or morbid or dangerous
habits or propensities ; whether it has occasioned any
failure of memory or understanding, or is connected
with epilepsy, or ordinary paralysis, or symptoms of
general paralysis, such as tremulous movements of the
tongue, defect of articulation, or weakness or unsteadi-
ness of gait.
4thly. Every particular which can be obtained
respecting the previous history of the patient; what
are believed to have been the predisposing and ex-
citing causes of the attack, what the previous habits,
active or sedentary, temperate or otherwise; whether
the patient has experienced any former attacks,
and if so at what periods; whether any relatives
have been subject to insanity, and whether the pre-
sent attack has been preceded by any premonitory
symptoms, such as restlessness, unusual elevation or
depression of spirits, or any remarkable deviation
from ordinary habits and conduct, and whether the
patient has undergone any and what previous treat-
ment, or been subjected to personal restraint.
5thly. During the first month after admission entries
to be made at least once in every week, and oftener where
the nature of the case requires it. Afterwards in recent
or curable cases, entries to be made at least once in
every month, and in chronic cases subject to little varia-
tion, once.in every three mouths.
An accurate record must be kept of the medicines
administered, and other remedies employed, and all
injuries and accidents should be stated.
That the several particulars hereinbefore required
to be recorded, to be set forth in a manner so clear and
Copy of
medical
certificates
to be sent to
office of
Commis
sioners
within
twenty-four
hours from
patient’s
admission.
Statement.
of mental
and bodily
health of
patient.
44 MANUAL OF LUNACY
distinct, as to admit of being easily referred to, and
extracted whenever the Commissioners shall so require.
And that the present order be in substitution for that of
the 9th of January, 1846, and that a copy thereof be
inserted at the commencement of the Case Book.
. Dated this 20th day of March, One thousand eight
hundred and sixty-three.
Office of Commissioners im Lunacy,
No. 19, Whitehall Place.”
Copy of Medical Certificates and Order.
A copy of these documents, according to the amended
Acts, must be sent to the Commissioners within twenty-
four hours from the patient’s admission. The copy of
the certificates must be a fac-simite of the original, con-
taining all erasures and alterations.
Statement of Mental and Bodily Health,
The patient must be examined by the medical attend-
ant after two clear days and before the expiration ot
seven clear days from the date of admission.
This statement must be sent to the Commissioners
in Lunacy by the proprietor or superintendent.*
Discharge of Patients.
Notice of the discharge of a patient must be given
to the Commissioners within two days from the discharge,
and must state whether the patient has been discharged
as “ recovered,” “ relieved,” or as ‘“ not improved.” +
The medical attendant is also required to make an
entry of the patient’s discharge in the Discharge Book.{
* A copy of this statement will be found in Schedule C at the
end of the Lunacy Act 1853 (16 and 17 Vict. c, 96), printed at the
end of the book,
t+ 8 and 9 Vict. c, 100, Schedule E 2,
¢ 8 and 9 Vict. c. 100, Schedule E 1.
ON THE MANAGEMENT OF ASYLUMS, ETC. 45
This is required to be done within two clear days from
the discharge.
Death of Patients.
Notice of death must be forwarded,
Ist. To the Commissioners in Lunacy, within two
clear days from the time of the death.
2nd. To the coroner of the district.*
8rd. To the person to whom notice of death has to
be sent, whose name is mentioned in the statement of
admission.
4th. To the parish registrar of deaths.
A copy of the notice to the Commissioners must be
entered in the Case Book.
Medical Journal.
The Medical Journal{ must be filled up and signed
every week, It must contain the number and names of
the patients who. have been under medical treatment
during the week, and also the nature of their bodily ail-
ment, the number of patients in the house, the patients
who have been restrained, or secluded, since the last
week’s entry, and the reason for this restraint or seclu-
sion; the names of those patients who have died, or
who have received any injury during the week.
Books to be placed before the Commissioners at the Time of
their Visit.
The following six books have to be placed before the
Commissioners in Lunacy at the time of their visitation :
1st. Medical Journal.
* 95 and 26 Vict. c. 111, s. 44.
¢ A form of the notice of death will be found at the end of the
book.
t Schedule D, 16 and 17 Vict. c. 96.
Notice of
death.
Medical
Journal,
what it is to
contain.
Official
books to be
placed before
Commis-
sioners at
time of their
visit.
Patients’
book.
Commis-
sioners’
entries in
official books
of the
asylum,
Escape of
patients,
notice to be
sent to Com-
missioners
within two
clear days.
Patient can
be recap-
tured within
fourteen
days,
46 MANUAL OF LUNACY
2nd. Book of Admission.
8rd. Book of Discharges.
4th. Case Book.
5th. Visitors’ Book. In this the Act of Parliament
is printed in full, and here the Commissioners write their
report and particulars of their visit.
6th. Patients’ Book.
In this book special remarks relating to individual
cases are made by the Commissioners.
All recent medical certificates have also to be placed
before the Commissioners.
Commissioners’ Entries in Official Books.
A copy of the entries made in the Visitors’ and
Patients’ Book must be sent to the Commissioners within
three days from their visitation, written on foolscap
paper. -A blank margin of about two inches had better
be made on the left-hand side of the copy, and a margin
of about half an inch on the right, leaving room for any
remarks to be made by the Commissioners in Lunacy at
their office.
: Escape of Patients.
If a patient escapes from a licensed or private house,
notice of the fact must be sent to the Commissioners in
Lunacy. Ifthe patient has escaped from a house not
within their immediate jurisdiction, the notice is then to
be sent to the visitors. In each case, the notice must be
sent within two clear days, and must contain the name
of the patient, his condition of mind at the time of the
escape, and the circumstances connected with it. Notice
of recapture must be sent to the Commissioners or
visitors, as the case may be, within two days from such
recapture. A patient who has escaped can be recaptured
within fourteen days, upon the original order and medi-
cal certificates ; if this time has elapsed, the medical cer-
tificates and order become invalid.
ON THE MANAGEMENT OF ASYLUMS, ETC. 47
Notice of escape and recapture may be sent at the
same time.
Transfer of Patients from one House to another after the
Lepiration of Licence.
If any licensed house is pulled down, or occupied
under the provisions of any Act of Parliament, or by
fire, tempest, or any other accident is rendered unfit for
the accommodation of lunatics, or if the proprietor of a
licensed house desires to remove his patients from one
house to another, the Commissioners have power to
grant to such person whose house has been rendered
unfit for occupation, and who shall desire to transfer his
patients, a licence for such time as the Commissioners
think proper. Seven clear days’ notice must be given
to the Commissioners of the proposed change, together
with plans, statement, and description of the new house
to which it is proposed to transfer the patients. (This
does not, of course, apply to cases of fire and tempest.)
Notice is also required to be sent to the persons who
signed the “ order,” or to the person who made the-last
payment.
Transfer of a Patient from one Asylum to another.
If it be deemed desirable to remove a patient from
one asylum to another, application must be made to the
Commissioners by the person who signed the “ order”
for admission, and upon this application the Commis-
sioners will communicate with the proprietor or super-
intendent as to the fitness of the patient for transfer.
If this be satisfactory, the person making the applica-
tion will receive from the Commissioners two copies of
‘the “consent” and “ order,” the “consent” signed
by two of the Commissioners, and the “ order” by the
person making application ; one of these documents is
left with the proprietor or superintendent at the asylum
A patient
can betrans-
ferred from
one house to
another
after expi-
ration of
licence.
A patient
can be trans-
ferred from .
one asylum
to another.
.
Consent and
order for
transfer,
Aperson who
has been
under
certificate
can be
received as
a boarder.
48 MANUAL OF LUNACY
from which the patient is removed, and the other copy,
together with an exact copy of the original order, state-
ment, and medical certificates, and endorsed by the
proprietor or superintendent as being a true copy, is
given to the proprietor or superintendent of the asylum
to -which the patient is transferred.
Copy or Consent AND ORDER FOR TRANSFER.
CONSENT.
We, the undersigned Commissioners in Lunacy, hereby consent to
the removal, on or before the day of , 187 ,
of »% private patient in House,
.yto House, 4
Given under our hands this | day of , in the
year of Our Lord One thousand eight hundred and seventy-
} Commissioners in Lunacy.
. ORDER.
I, the undersigned, having authority to discharge 7
@ private patient in . House, ; hereby
order and direct that the said be removed there-
from to House, é
Given under my hand this day of , in the
year of Our Lord One thousand eight hundred and seventy- ‘
(Signed)
Place of abode, ‘
Boarders in Asylums.
A person having been a certified patient in an asy-
lum, can be received as a boarder, provided he has been
a patient in any asylum, hospital, or licensed house, or
under care as a single patient, within five years from the
time he wishes to become a boarder.
This is a very necessary’ and beneficial arrangement,
for many persons who have been previously in asylums,
conscious of a want of control, and recognising a re-
currence of the malady, have an opportunity of volun-
tarily placing themselves under treatment.
ON THE MANAGEMENT OF ASYLUMS, ETC. 49
Boarders must enter the asylum of dns own free
will, and while there are free agents, and are at liberty
to leave whenever they please.
It was formerly required that the Commissioners in
Lunacy should have a personal interview with the pro-
posed boarder, before giving their sanction to his resi-
dence in an asylum.
The preparatory arrangements are simply these :—
The person desirous of becoming a boarder makes a
written. application to the Commissioners, expressing his
wish to reside in the asylum for a definite period. Two
of the Commissioners, if they think proper, give their
consent in writing. At the expiration of the time for
which permission is given, a fresh application must be
made to the Commissioners, and their consent obtained.
The medical superintendent cannot receive a boarder
if he exhibits symptoms of mental unsoundness. Boarders
‘do not count among the number of patients for which
the house is licensed. If an asylum is licensed for twenty
patients, and the house has sufficient accommodation,
boarders can be received in excess of that number.
Their names are not entered in the Case Book or
Book of Admission.
“In very few cases as yet has advantage been taken
of the provisions of the eighteenth section of the Lunacy
Acts Amendment Act, 1862, legalising the reception
into,and the retention in licensed houses, as boarders, of
persons who may have been within five years immedi-
ately preceding patients in any asylum, hospital, or
licensed house, or under care as ‘single patients.’ As
respects provincial licensed houses, the fact of the resi-
dence therein, with the assent of the visitors, of such
voluntary boarders comes only to the knowledge of the
Commissioners incidentally upon- the occasion of their
visits.
It is very desirable that in all cases of this kind
E
No person
can. be
received as
a boarder
if he exhibits
symptoms
of mental
unsound-
ness,
Remarks of
the Com-
missioners
on board-
ers.
50 MANUAL OF LUNACY
notice should be transmitted by the proprietors or
superintendents to this office, and it is important that
all boarders should be seen, whenever licensed houses
are visited, with a view to ascertain beyond a doubt that
they are of sound mind, and entirely free agents, and
that they fully understand their position.
The necessity for such interviews with boarders has
recently been strongly exemplified in the cases of two
gentlemen in a metropolitan licensed house, to whose re-
ception and residence as boarders our assent was duly
given upon their written application. Both had been pre-
viously patients in the same house, and discharged
therefrom as recovered.
Upon the occasion of a visit by two members of this
Board, who conversed privately with the gentlemen
referred to, it transpired that neither of them was aware
of his being a free agent in all respects and at liberty to
leave the house.
They both stated that dey had been given by the
proprietor and superintendent to understand that they
were bound to remain and submit to the regulations of
the establishment for the full period limited by the
assent of the Commissioners. On enquiry it was found
that the proprietor or superintendent had, in fact, so
informed the gentlemen, and the explanation of so
singular a misconstruction of the Act was, that the per-
mission thereby given was to ‘ entertain and keep as a
boarder.’ 7
Tn the case of one of the gentlemen he was found to
be in such a mental state as to be incapable of forming
a rational wish upon the subject, and he was removed
by his frierids.
In the other case the permission to continue to
reside as a boarder was, in compliance with the desire
of the gentleman in question, for the remainder of the
limited period left undisturbed ; he, however, shortly
ON THE MANAGEMENT OF ASYLUMS, ETC. 51
afterwards relapsed into a state of mania, and was again
placed under certificates.” *
Correspondence of Patients.
All letters written by patients in asylums, hospitals,
or licensed houses, or by a single patient, and addressed to
the Commissioners in Lunacy, or to the Committee, and,
in the'case of houses within the immediate jurisdiction
of visitors, to the visitors, must be forwarded unopened.
All letters. written by patients so confined, and addressed
to other persons, must be forwarded to the persons. to
whom they are addressed, unless endorsed by the person
who has charge of the patient, thus—Not to be sent.
The letters are initialed, and must be placed before the
visiting Commissioners, Committee, or visitors, as the
case may be, at the next visitation.
Any superintendent, proprietor, or person in charge
ef a single patient, failing to observe this provision is
liable to a fine of 20%.
Iil-treatment or Neglect of Patients.
“Tf any superintendent, officer, nurse, attendant,
servant, or other person employed in any registered hos-
pital or licensed house, or any person having the care or
charge of any single patient, or any attendant of any
single patient, in any way abuse, ill-treat, or wilfully
neglect any patient in such hospital or house, or such
single patient, or if any person detaining, or taking or
having the care or charge, or concerned or taking part
in the custody, care, or treatment, of any lunatic or
person alleged to bea lunatic, in any way abuse, ill-treat,
or wilfully neglect such lunatic or alleged lunatic, he
shall be guilty of a misdemeanour, and shall be subject to
‘indictment for every such offence, or to forfeit for every
* Commissioners’ Eighteenth Report, 1864,
E2
Letters
written by
patients in
asylums.
Any person
who wilfully
ill-treats a
patient is
liable to
a fine.
Tllegal de-
tention of
patients.
Commis-
sioners have
power to
give infor-
mation as
to the con-
finement
of patients.
Orders
for visita-
tion of
lunaties by
their friends.
52 MANUAL OF LUNACY
such offence, on a summary conviction thereof before two
justices, any sum not exceeding twenty pounds.”’*
Unjust Confinement of Patients.
Any patient who has been discharged from an asylum,
and who considers himself to have been unjustly con-
fined, can apply to the Secretary of the Commission-
ers for a copy of the order and medical certificates
upon which he has been detained, and he is furnished
with such, without any fee.
If the Commissioners and visitors of an asylum
report concerning the unjust confinement or ill-treat-
ment of a patient, the Home Secretary is empowered
to direct the Attorney-General to prosecute on the part
of the Crown.
Search for Persons confined in Lunatic Asylums.
Any person desirous of ascertaining whether any
particular patient is confined in a licensed house, the
Commissioners have the power upon receiving an appli-
cation to order their Secretary to examine and give in-
formation concerning the patient. This only applies
to a person who has been confined as a lunatic within
twelve months from the time of the application. Of
course it is left entirely to the discretion of the Com-
missioners whether such information be given or refused.
In the case of patients who are not within the im-
mediate jurisdiction of the Commissioners, application
must be made to one of the visitors.
Visits of Friends to Patients.
In most private asylums the patients are allowed to
be visited by their friends and relations at any hour
during the day.
If access to the patients is refused, a Commissioner
or visitor, as the case may be, is enabled, should it be
* Lunacy Act, 1858.
ON THE MANAGEMENT OF ASYLUMS, ETC. 53
deemed desirable, to give an order for the admission of
a friend to visit the patient at all reasonable times, and
any person refusing to obey such order, or who en-
deavours to prevent these visits, renders himself liable
to a fine not exceeding 201.*
Temporary Leave of Absence of Patients.
It is lawful for the person who has signed the order
for a patient’s admission into an asylum, or for the per-
son who made the last payment, to apply to the Commis-
sioners for his temporary leave of absence under proper
care. Before the Commissioners grant this request, the
medical superintendent must state in writing that this
change is for the benefit of the patient. It is customary
for a written application to be made to the medical super-
intendent by the friends of the patient, and this applica-
tion is forwarded to the Commissioners by the medical
superintendent, with a letter from himself stating that the
change will be beneficial, and also whether the person
making the application, which is enclosed, signed the
order, or made the last payment.
Power of Commissioners to obtain Evidence.
The Commissioners have the power of summoning
any persons before them, and examining them upon
oath, concerning any matter relating to the Lunacy Acts.
Attendants.
One of the most important things connected with the
management of asylums is to ensure a well-regulated
staff of skilled attendants.
The Commissioners in Lunacy, with a view of assist-
ing the proprietors of asylums and medical superinten-
* With regard to the advisability of seeing the patient the friend
should be guided by the advice of the medical officer, as serious
consequences often follow the injudicious visits of friends.
Patients on
leave of
absence.
Attendants.
54 MANUAL OF LUNACY
dents to obtain respectable and trustworthy attendants,
forwarded a notice to the superintendents of all metro-
politan asylums, requesting to be furnished with a list of
attendants engaged since the commencement of the year.
This list must contain the age of each attendant, the
time at which the attendant was engaged, and in what
capacity ‘he is to act, the wages he is to receive, the
name of the place of his previous employment, and
occupation.
The Commissioners require notice of the engagement
or discharge ofan attendant. I give below the form of
notice which has to be sent to the Commissioners within
three days of the admission or of the discharge of an
attendant. i is filled up with the name of a fictitious
person.
NOTICE OF THE ENGAGEMENT OF AN ATTENDANT.
Copy of Newton Asylum, Feb. 17, 1873.
notice to be C . pis
sent to Com- I hereby give you notice that William Thompson, .aged 35, was
aihon ‘engaged by me as attendant on the 17th day of February, 1873, at
engagement the rate of 25/. per annum, increasing 51. per annum up to 501., and
oF a nk: that his previous occupation was that of an attendant in Eltham
House, Barnstaple, in December, 1872.
(Signed) William Wallace,
Proprietor of Newton Asylum, Newton.
The Secretary,
‘Commissioners in Lunacy.
NOTICE: OF THE DISCHARGE OF AN ATTENDANT.
Newt
ae ewton Asylum, March 4, 1873.
notioe 2 be I hereby give you notice that William Thompson, an attendant
sertionere in this house, who was engaged on the 17th day of February, 1873,
on the a was discharged on the 4th day of March, 1873, in consequence of
on atten. being intowicated,* and neglect of duty.
dant. é
om (Signed) William Wallace,
: Preprietor of Newton Asylum, Newton.
The Secretary,
Commissioners in Lunacy.
* The real cause for dismissal must be here definitely stated.
"ON {HE MANAGEMENT OF ASYLUMS, ETC. 55
The Commissioners keep a record of the names
of the attendants in the various licensed houses, and
the facts relating to them, and this is at all times ac-
cessible to the proprietors of licensed houses, The
wages in first-class private asylums, of a male atten-
dant, generally commence at 301. per annum, increasing
dl. per annum up to 501. with a certain extra allow-
ance per month when the attendant is engaged on a
call, ie., upon attendance on a patient not residing in
the asylum. In some asylums the wages are much less ;
but if the wages are upon a low scale, the services of a
high-class attendant cannot be obtained.
The duties of an attendant, if properly and conscien-
tiously performed, are arduous and responsible; and
“consequently they should be liberally remunerated.
The Commissioners in Lunacy in their last report
have drawn special attention to the small proportion of
attendants in relation to the number of patients in pub-
lic asylums,
Record of
attendants
kept by
Commis-
sioners.
Wages of
attendants.
Attendant’s
duties,
56 MANUAL OF LUNACY
CHAPTER VY.
PRIVATE PATIENTS.
Proceedings necessary for Admission of Private Patients
into Asylums.
Lepab daca. As previonsly stated, no person alleged to be insane or of
necessary unsound mind can be received into an asylum without an
or the
reception of order; statement, and two medical certificates, as required
into an by the Lunacy Act.
asylum.
Order for Admission.
The order must be signed by a relative, friend, or
some person authorised to place the patient under
legal restraint ; and as a rule it is desirable that this
should be done by the nearest relative of the alleged
lunatic.
The order can be signed either before or after the
medical certificates, but itis necessary for the person who
signs to have seen the patient within one month from the
date of the order.
Persone who The following persons are prohibited from signing
hibited from the order for admission :—
nee ~~ 1, Any person receiving any percentage on or other-
wise interested in the payments to be made by or on
account of any patient received into a licensed or other
house.
2. The term medical attendant is thus defined :-—
“Every physician, surgeon, and apothecary who shall
keep any licensed house, or shall in his medical capacity
PRIVATE PATIENTS” 57:
attend any licensed house, asylum, hospital, or other
place where any lunatic shall be confined.” *
8. The father, son, brother, partner, or assistant of
either of the medical men who sign the certificates, or
who himself has signed one of the certificates.
Legally the person signing the order is responsible
for the maintenance of the patient during his residence
in the asylum, and no patient can be discharged except
by the direction of: the Commissioners, without the au-
thority of the person who signed the order.
For example, if the order for admission be signed by
a brother of the patient, neither the father nor any other
relative can authorise his discharge without first ob-
taining the consent of the brother who signed the order.
There is a special provision by whieh, under certain
specified circumstances, authority is given to other per-
sons, who did not sign the order for admission, to dis-
charge the patient.t| If the person who signed the order
_ be dead, mentally incapable, or absent from England, the
person who made the last payment on account of such
_ patient, or the husband or wife, or (if there be no hus-
.band, or the husband or wife be incapable as aforesaid),
the father or (if there be no father, or he be incapable as
aforesaid) the mother of such patient, or (if there be no
mother, or she be incapable as aforesaid) then any one of
the nearest of kin, for the time being, of sueh patient,
may by writing, under his or her hand, give such direc-
tions as aforesaid, for the discharge or removal of
such patient, and thereupon such patient shall be forth-
with discharged or removed.
The order for admission is in the form of a request
.made to the proprietor of the asylum to receive the
patient, and not, as in the case of pauper lunatics, a post
tive injunction.
* 8 and 9 Vict. c. 100, s. 114,
t+ 16 and 17 Vict. ¢. 97, 8, 84,
The person
who signs
order can
authorise
patient’s
discharge.
Provision
where the
person who
signed the
order for
reception
is dead or
incapable
of acting.
Order for
admission
is simply a
request.
Order avail.
able for one
month.
Mistakes
frequently
made in
fillmg up
the order.
All correc-
or Medical
Certificates
must be
initialed by
the person
who makes
the alter-
ations.
Fourteen
days from
date of
signing of
medical
certificates
allowed for
alterations.
58 MANUAL OF LUNACY
The wording of the order for admission of a private
patient is, ‘I request you to receive,” whilst that of the
order necessary for the reception of a pauper lunatic
being “I hereby direct you to receive.”
The order is available for one month from its date,
and the patient can be admitted any time within this
period.
A mistake most generally made in filling up the order
is the omission of the name of the patient, after the
words “respecting the said” The name has to
be repeated twice; first, after the word “receive,” and
‘then again after the words “respecting the said.”
An omission of this kind destroys the legality of the
document unless rectified.
The person who signed the order is required to make
the necessary alterations, and these, as well as all
erasures, or corrections, must be initialed.
Fourteen days from the signing of the medical cer-
tificates are allowed for alterations, and if not made in
that time the documents cease to be valid, and the patient
must be discharged from the asylum.
The order on the following page will illustrate what
I mean by the alteration or correction being initialed.
It will be seen that the word “ Solicitor’? has been
erased and consequently initialed. The words “ mentally
disordered” having been substituted for the terms used
in the Act, “lunatic, idiot, or person of unsound mind,”
are erased and initialed, it being absolutely RE ESIAEY,
for one of these terms to be used.
PRIVATE PATIENTS 59
ORDER FOR THE RECEPTION OF A PRIVATE PATIENT.
Sched. (A) .No. I., Sects, 4,-&
I, the undersigned, hereby request you to receive Thomas Wilson,
whom I last saw at 4, Faversham Road, Kensington, on the third
‘ of unsound mind
day of April, 1873, (a) a (5) person ‘sherely aneneers (Z., W.), as
@ patient into your house. ~
Subjoined is a statement respecting the said Thomas Wilson.
(Signed) Name Henry Wilson. Seticites (H. W.)
Occupation (if any) Solicitor.
Place of Abode 4 4, Faversham Road, Kensington,
or other circumstances of
connection with the Patient
Degree of relationship (if any),
Father.
Dated this 3rd day of April, One thousand. eight hundred and
seventy-three,
To Dr. Wilkins,
(ce) Proprietor of (d) Eltham House, Barnstaple.
Statement.
Following the order is the “ Statement,” embodying a
number of questions, all of which must be answered with
the greatest care and truthfulness.
Jt may be signed by the person who signed the
order or by any other person.
Generally both order and statement are filled up and
signed by the same person.
(a) Within
one month
previous to
the date of
the order.
(6) Lunatic,
or an idiot,
or @ person
of unsound
mind,
(c) Proprie-
tor or super-
intendent of
(4) Deserib.
ing the
house or
hospital by
situation
and name
(if any).
Statement.
(e) Where
the person
signing the
statement
is not the
Dero: —
signs the
order, the
following
particulars
concerning
the person
signing the
statement
are to be
added.
60 MANUAL OF LUNACY
STATEMENT,
If any Particulars in this Statement be not known, the Fact to be so
stated,
Name of patient, with mae Thomas Wilson.
name atlength .
Sexandage . . . « Male. 26.
Married, single, or widowed . Single.
Condition of life, and previous
occupation (if any) :
aoe ee as = as . CTech of ‘England.
Previous place of abode . *. 4, Faversham Road, Kensington.
Whether first attack . ‘i » Yes. ;
Age (if known) on first attack . 26.
shia and where previously un- } Nowhere.
er care and treatment .
Duration of existing attack . One week.
} Barrister-at-law.
Supposed cause. . . Mental anxiety.
Whether subject to epilepsy » No. :
Whether suicidal . as . Yes.
Whether dangerous to others . No,
Whether found lunatic by inqui-
sition, and date of commission \ No
or order for inquisition . ne! 4
Special circumstances (if any) }
preventing the patient being |.
examined, before admission, } None.
separately by two medical
practitioners . .
Name and address of relative fo
whom notice of death to be \ To myself, as below.
sent . . . . '
(Signed) Name(e) Henry Wilson.
Occupation (if any) Solicitor.
Place of Abode 5 4, Faversham Road, Kensington.
Degree of relationship (if any),
or other circumstances of}
connection with the Patient
Father.
In order to assist us in forming a correct prognosis
PRIVATE PATIENTS 61
of the case, it is desirable to know whether it is the first
attack, or if not, how many previous attacks the patient
has had ; the exact age on his first attack ; the duration
of the existing illness, and whether there is any consti-
tutional predisposition to insanity.
The statement, as is the case with the order, is often
carelessly worded. In numerous instances the supposed
cause is said to be wnknown. This answer is not satis-
factory, as it prevents the medical officers of the asylum
from forming a correct diagnosis of the case.
If the statement is carefully and truthfully filled up,
the medical officers connected with the asylum are ma-
terially aided in arriving at a right conclusion as to the
origin of the mental disorder.
’ Take for illustration the case of Thomas Wilson,
filled up in the “statement.” The following answers to
the questions would lead us to entertain a favourable
prognosis :—
1. The patient having had no previous attack.
2. The short duration of the illness,
3. The “supposed cause,” mental anxiety. (A very
common cause.) . In such a case, cwteris paribus, the
prognosis would be favourable.
4, The patient not being epileptic. In insanity asso-
ciated with epilepsy or with epileptiform seizures, the
prognosis as a rule is most unfavourable.
5, The age of the patient.
If these interrogatories lare carefully answered, the
medical officer is greatly assisted in forming an accurate
opinion of the case.
One of the most important questions in the statement
has reference to the “supposed cause” of the insanity.
Great difficulty often exists in obtaining any information
on this point from the patient’s friends; the answer
given to the question is, that no cause can be assigned,
or that the cause is unknown.
Care is
requisite to
fill up the
statement
properly.
The state-
ment
frequently
carelessly
filled up.
Example of
a case in
which the
prognosis
would be
favourable
from con-
sideration of
facts men-
tioned in
statement.
Supposed
cause of the
insanity.
Special
circum-
stances in'
which only
one medical
certificate is
necessary.
Procecdings
subsequent
toa patient’s
admission
on one
certificate.
62 MANUAL OF LUNACY
It rarely happens that a distinct cause cannot be dis-
covered, although the friends object to mention it in the
statement.
“Effect of an injury to the head,’ “ sunstroke,”
“long exposure to a tropical climate,’’ ‘‘ intemperate
habits,” “loss of property,’ “domestic grief,” “mental
worry,” “repeated attacks of delirium tremens,” “ effect
of an acute attack of inflammation of the brain,” or
* softening or other organic disease of the brain,”’ “ long.
continued epilepsy,” “‘ hereditary predisposition,” “ sud-
den accession of fortune,” ‘‘ mental shock,” “ deficient
nutriment,’’—any one of these causes would be a proper
answer to the question.
Another part of the statement requiring to be
noticed alludes to the question relating to the special
circumstances which have prevented the patient from
being examined and certified by “‘two’’ medical men
prior to admission, It is in some instances of the
greatest importance to place a patient, in consequence
of a sudden attack of mania, under immediate medical
treatment. It occasionally happens that im such a
ease the two medical certificates required by the Act
cannot be obtained. For example, in an acute case
of insanity occurring in a small village, in which only
one medical man resides, it may be found absolutely
necessary for the patient to be placed without delay:
under care and treatment, and this can legally be done
on the certificate of one qualified practitioner, but the
special circumstances which have prevented the second
certificate from being obtained must be clearly stated in
the latter portion of the statement.
If a case is admitted into an asylum on one certi-
ficate, the patient must be examined by two medical
men within three clear days from his admission into the
asylum, and the two additional certificates must be for-
warded to the Commissioners within that period. The
PRIVATE PATIENTS 63
medical men who sign the certificates, after the admission
of the patient, must not be in partnership with each
other, or connected with the medical man who signed
the first certificate upon which the patient was received,
or related to the proprietor or superintendent of the
asylum, or interested in any way in such asylum. The
examination, as in the case with ordinary medical cer-
tificates, i is required to be made separately, and not in
the presence of any other medical man.
The order, statement, and medical certificates need
not necessarily be made on the printed form contained
in the schedule of the Act, but may be written on or-
dinary paper, provided the exact and literal wording
of the official documents is strictly adhered to; it is,
however, always desirable to use the printed form if
one can be obtained.
The statement should specify whether the patient
is hereditarily predisposed to insanity. In the state-
ment of pauper lunatics there is a special paragraph
relating to this matter.
Medical Certificates.
No patient, except under special circumstances, pre-
viously referred to, can be admitted into an asylum
without two medical certificates.*
The medical certificates can be signed before or after
the order and statement, but this must be done within
seven clear days from the date of the examination of the
alleged Iunatic, and the patient can only be admitted
within seven days from this examination. It may be
dated and signed any time between the examination and
reception of the patient. The medical men who sign
the certificates must be in actual practice and duly
registered, in order to render the certificates valid.
* This does not apply to Chancery patients or pauper lunatics,
Order and
statement
need not be
printed,
Medical
certificates.
Signed
before or _
after the
order, and
available for
seven days.
from date
of exami-
nation.
Certain
persons
prohibited
from signing
the medical
certificates.
Remarks of
Commis-
sioners
concerning
medical
certificates.
64 _ MANUAL OF LUNACY
Persons prohibited from Signing Certificates in Lunacy.
There are certain persons who, although qualified
to practise, are nevertheless prohibited from signing the
medical certificates.*
Ist. Any person receiving any percentage on, or
otherwise interested in, the payments to be made by or
on account of any patient received into a licensed or
other house.
Qndly. Any medical attendant, as defined by the
Lunacy Act. .
8rdly. The medical men who sign must not be in
partnership or professionally connected.t
4thly. The medical certificates cannot be signed by
the father, brother, son, partner, or assistant of the
person having the care or charge of the patient, and no
physician, surgeon, or.apothecary who, or whose father,
brother, son, partner, or assistant shall have signed the
order for admission can sign the certificate. *
If a medical man desires to place his wife in an
asylum, he can sign the order, but cannot, although
a legally qualified practitioner, sign either of the medical
certificates. .
The Commissioners in their fifteenth Report (dated
March 31, 1861, page 65) refer to the great care
necessary in order to make these certificates legally
valid. ‘ Few of our duties require more vigilance than
that of satisfying ourselves in all doubtful cases as to
the validity of the orders and certificates on which
patients: are admitted into asylums, or become subject
* 25 and 26 Vict. e. 111, 5. 114.
t It is not absolutely necessary that the medical man certifying
should specify his medical or surgical degrees or qualifications, but
he may describe himself as “a duly qualified registered practi-
tioner.”
PRIVATE PATIENTS 65
to detention in any place. From time to time we have
issued printed instructions with the view of ensuring, as
far as possible, on the part of superintendents, pro-
prietors, medical practitioners, and others an accurate
compliance with the requirements of the law. Immediate
steps are taken for correction upon discovery of defects
or omissions; and where this is not found to be practicable,
the substitution of new and valid certificates, or, as the
unavoidable alternative, immediate discharge of the pa-
tient from illegal detention under certificates having no
validity has been insisted on.
Among such cases of the past year one may be Discharge
specially referred to because of the importance of the e ao
questions involved in it. By the statute the certifying fe eanacrtt
medical man is required to set forth in the certificate of inuf
not merely his opinion of the insanity of the person fact, and
& : sas : s inability to
examined, but the specific fact or facts indicating in- fmena the
sanity on which that opinion is formed; in the body of ¢2rtifcates:
the certificate the date and place of examination are to "tisfaction.
be exactly stated; each medical man, where two certi-
ficates are necessary, is to examine the patient separately
and apart from the other practitioner; and, if such
examination has taken place at any period beyond seven
days before admission of the patient into the house or
- asylum where he is detained, the certificates are invalid,
and detention under them becomes illegal. The object
of all these precautions is to provide that no one shall
be deprived of his liberty as a person of unsound mind
except upon specific grounds, existing at the exact time
when it is proposed to place such person under restraint.
It would of course be impossible that any examining
medical man should exclude from his consideration facts
known to him of the antecedents of the patient, imme-
diate or remote. These are entitled to their full influence;
but the Legislature has been careful to guard against such
facts exercising undue influence in the certificate he is
F
Mistakes
render the
certificates
invalid if not
amended
within
fourteen
days from
the reception
_of the
patient.
66 MANUAL OF LUNACY
called on to give, by requiring that this certificate shall be
directly deducible from examination on a particular day
and at a specified place, and that the opinion expressed
therein as having been formed on such particular day
shall be set forth as the result of his having observed
at that time in the person under examination some
specific fact indicating insanity.
In the case to which allusion has been made no such
specific fact was stated in either certificate, and upon
the necessary forms of amendment being suggested, it
was found that the certificates of both the medical men
were not given on what they observed on any particular
day, but that, having attended the patient professionally
for a considerable period, they had not any doubt from
her ordinary course of conduct that the patient was of
unsound mind, and that it was on this opinion they
based their certificates. We had no alternative in
these circumstances but to direct the discharge of the
patient, in order to obtain a fresh examination and cer-
tificates in compliance with the law.”
It frequently happens that, in consequence of an
apparently trifling mistake, the certificate becomes in-
valid, and, if not amended, the patient, though a dan-
gerous lunatic, must be discharged.
As before mentioned, the certificate is only valid
for seven days from the date of the examination of
the patient. If a mistake is found in the certificate it
will be returned by the Commissioners for alteration. ‘
This alteration must be made within fourteen days
from the reception of the patient, and if not done
to their satisfaction the Commissioners, or any two of
them, can authorise the discharge of the patient. Every
alteration and correction, as is the case with the order
and statement, must be initialed.
The medical certificates must accwrately specify:
1st. The date and place of examination; 2nd. The
PRIVATE PATIENTS 67
exact residence, with the number of the house, where
the patient resides. These facts are of great impor-
tance, and without their specification the certificate
is invalid. Serious inconvenience often results from
these particulars being misstated and not properly
corrected within the period allowed for amendments.
The medical men who 'sign the certificates are
required to investigate the case thoroughly, so as not to
state “facts” as delusions, without first assuring them-
selves that they are not based upon reality, but simply
pure emanations from the insane imagination of the pa-
tient. For example, a person affirms that he is ruined,
but before this can be stated as a delusion in the certi-
ficate certain enquiries must be made in order to ascertain
whether there is any foundation for this impression.
Medical men are liable—and justly so—to an action at
law on the ground of negligence if they sign a certifi-
cate without enquiring into the truth of the facts (should
these facts admit of investigation) stated in their certi-
ficates as evidences of insanity necessitating restraint.
Of course there are ideas which are so obviously of
an insane character, that it would be absurd to entertain
any doubt as to their nature. They are piimd facie.
symptoms of mental aberration, and no questions need
be asked about them. The certificate on the following
page is given as an illustration.
F 2
Truth of the
“ facts ”
stated
must be
thoroughly
enquired
into.
68
MANUAL OF LUNACY
MEDICAL CERTIFICATE.
Sched. (A) No. IL, Sects. 4, 5, 8, 10, 11, 12, 13.
(a) Here set forth the qualifica-
tion entitling the person certifying to
practise as a physician, surgeon, or
apothecary, ex. gra. :—Fellow of the
Royal College of Physicians in Lon-
don, Licentiate of the Apothecaries’
Company (or as the case may be).
(6) Physician, surgeon, or apothe-
cary (ag the case may be).
(c) Here insert the street and num-
ber of the house (if any), or other
like particulars. 3
(d) Insert residence and profession,
or oceupation (if any), of the patient.
(e) Lunatic, or an idiot, o7 a person
of unsound mind.
I, the undersigned, being « (a) Member of
the Royal College of Surgeons, England, and
being in actual practice as a (b) Surgeon,
hereby certify that I, on the 8rd day of
April, 1873, at (c) 4, Faversham Road, Ken-
sington, in the county of Middlesex, sepa-
rately from any other medical practitioner,
personally examined Thomas Wilson, of (d)
4, Faversham Road, Kensington, barrister,
and that the said Thomas Wilson is a (e)
(f) Here state the facts.
person of unsound mind, and a proper person
to be taken charge of and detained under care
and treatment, and that I have formed this
opinion upon the following grounds, viz. :—
myself: (f)
1. Facts indicating insanity observed by
.
(g) Here state the information, and
from whom.
He is under the delusion that he is
ruined, and that the sheriff's officers
are waiting in the house to remove
him. He is very desponding and low-
spirited, and says his soul is completely
lost, having committed the wnpardon-
able sin.
2. Other facts (if any) indicating insanity
communicated to me by others: (g)
His brother, John Wilson, tells me that
the patient, Thomas Wilson, for the last
Sew days has been in a desponding state
of mind, and has made several attempts
at self-destruction.
(Signed) Name Alfred Cowan.
Place of Abode
44, Faversham Road,
Kensington.
Dated this third day of April, One thousand
eight hundred and seventy-three.
PRIVATE PATIENTS 69
In signing a certificate there are two conclusions to
be arrived at :-—
1st. That the patient is a person of unsound mind. ~
2nd. That he is a proper person to be placed under
restraint,
The medical men signing must consider carefully
these two points before certifying.
Medical certificates are frequently carelessly written,
and are, in consequence of inaccuracies, returned by the
Commissioners for correction.
Mistakes in the certificates are often caused by the
medical men omitting to read the marginal notes printed
on the official document for their instruction. The
following omissions are frequently made :—
ist. The name of the street and number of the
house at which the examination of the patient is made.
An omission of this kind renders the certificate
invalid, and if it is not rectified within fourteen days
the patient must be discharged.
Should there be no number to the house where the
patient is examined the fact must be mentioned.*
Qnd. A very common mistake is omitting to state
the occupation (if any) and address of the patient.
3rd. he name of the informant in the second part
of the certificate must be given.
It will not be sufficient to say, ‘ His brother, wife,
or his sister tells me so and so.” if the name of the
informant is not given, the certificate will be returned
by the Commissioners.
Discharge of a Patient in consequence of Insufficient Facts.
I will cite one case from the 17th Report of the
Commissioners in Lunacy, dated June 9, 1863.
* If there should be a particular name by whieh the house is
known, it should be stated, as, for instance, “Ivy Cottage,” “* Holly
Lodge,” “ Laburnum Villa,” “The Firs,” &¢., &e,
Conclusions
to be arrived
at before
signing a
certificate
of lunacy.
Omissions
frequently
made in
certificates.
Discharge of
patient by
Commis-
sioners in
Lunacy in
consequence
of defective
certificate,
70 MANUAL OF LUNACY
We have had occasion in one case to exercise the
powers vested in us by the 27th section of the ‘ Lunacy
Acts Amendment Act 1862,’ by ordering the discharge
of a patient from a county asylum, on the ground of a
defective medical certificate.
E. A., a female pauper lunatic, chargeable to the
Bosmere and Claydon Union, was received into the
‘Suffolk County Asylum, upon the usual order of ajustice,
and a medical certificate signed by Mr. J. Pennington, a
surgeon, wherein under the head ‘Facts indicating
insanity, observed by myself,’ he stated as follows :—
“None, but a stupid, sulky, obstinate temper.’ The
other facts indicating insanity, set forth as having been
communicated to him by others, were the following :—
‘Extremely indecent; exposure of her person on all
occasions, public as well as private; attempting to cut
her throat, as well as to strangle another girl; these
facts communicated to me by the nurse and deputy-
matron.’ In this certificate it will be noticed that the
facts observed by Mr. Pennington himself, taken alone,
were not indicative of insanity, and that what he had
certified, therefore, did not satisfy the provisions of the
“Lunatic Asylums Act 1853,’ s. 75, which declares
that, ‘ No person shall be received into any asylum under
any certificate which purports to be founded only on
facts communicated by others.’ The facts stated must
plainly be of a kind indicating insanity, and no such
facts were, according to his averment, observed by Mr.
Pennington.
In these circumstances, the Board felt that they had
no option in the case, and were bound to insist upon an
amendment of the certificate.
It is not necessary to set forth in detail the cor-
respondence which passed upon the subject, and which
extended over a period of three months. Every effort
PRIVATE PATIENTS 71
was made on the part of this Board to procure a sub-
stantial compliance with the Act. The visitors of the
asylum declined to interfere, and Mr. Pennington ulti-
mately stated that he had nothing to add to his certificate.
This was after the Commissioners had communicated to
the visitors their opinion, that it was impossible legally
to detain E. A. under the certificate of Mr. Pennington,
and had said that, unless a valid certificate were pro-
cured in its place, they would be obliged to exercise the
power conferred on them by the recent Act and order
her discharge.
Accordingly an order for that purpose was made by
two members of the Board on January 3, and, in obe-
dience thereto, E. A. was discharged, and removed on
the 16th, a fortnight having been allowed for that pur-
pose. Dr. Kirkman, the superintendent of the asylum,
to whom the order was transmitted, was informed that,
considering the nature of the case (which was reported
to be one of epileptic mania), the Commissioners had
made the order with great reluctance ; but that the
manifest defect in Mr. Pennington’s certificate, and the
neglect either to amend the same or to procure a fresh
one in its place, left them no choice in the matter. He was
at the same time requested at once to communicate on the
subject with the relieving officer, in order that, with the
least possible disturbance to the patient, she might be re-
admitted into the asylum on a fresh order and certificate.
No notice has been received of her readmission.”
“ Facts of Insanity observed by myself.”
The most important part of the certificates relates Facts of
to the evidence of insanity observed by the medical men mast be
who sign them. The facts therein stated must clearly ok
establish the existence of mental unsoundness, and such ‘medical
unsoundness of mind as to justify the confinement of the
72 MANUAL OF LUNACY
patient in an asylum or elsewhere. It will not be sufficient
for the person signing to say, he thinks So-and-so to be
insane, or believes him to be so, or that he has the
appearance of being of unsound mind, or that his
actions indicate the presence of insanity, or that he
hears that the person alleged to be insane has been guilty
of conduct not consistent with the supposition of his mind
being in a sound state; that his general conversation is
symptomatic of insanity, or that he is wasting his pro-
perty, and is unable to take care of himself or to
manage his affairs. Facts referable to all these points
no doubt are important, particularly when considered in
relation to actual mental delusions or other evidences of
alienation of mind, but per se they do not justify a cer-
tificate or legal confinement. All vague, hypothetical,
and loose generalisations should be studiously avoided
when signing the certificates.
Facts, specific facts only—which the medical man him-
self has observed atthe time of signing—should be clearly
stated. If this injunction is not strictly acted upon, the
certificate will be valueless. It should be the medical
man’s object to discover, if practicable, the presence of
defined delusions, hallucinations, or illusions. In some
cases it may be-extremely difficult to detect the insane
idea inciting the patient to overt acts of madness jus-
tifying restraint. It may be cunningly concealed for a
purpose, or the lunatic may obstinately refuse to give
utterance to his insane thoughts, and be doggedly silent
when closely questioned on the-subject. Again, there
are states of mental unsoundness which apparently are
unconnected with any perceptible delusions or insane
impressions—such as in some cases of acute melancholia,
imbecility, or homicidal mania. But as a rule, morbid
delusions may be detected in nearly all cases of insanity
requiring restraint. One distinctly defined fact in-
dicative of insanity will be more valuable than whole
PRIVATE PATIENTS : 73
pages of ambiguous speculations or loose surmises. For
example, a belief in the commission of the “sin against
the Holy Ghost,” or the “unpardonable sin” (common
delusions among the insane), or the existence of a delu-
sion that the patient has come into the possession of, or
is entitled to, a fabulous amount of wealth, or that his
relatives or friends are conspiring against him, that the
police are in search of him and are about to arrest him for
committing some imaginary crime, or that he (although
in the possession of ample means) believes himself to be
ruined, and that consequently he is to be placed in the
workhouse. In numerous cases of acute melancholia
delusions will be found relating to religious subjects,
such as the patient believing that his soul is lost, that
- God has forsaken him, that he is satanically possessed,
that he is in hell and doomed to everlasting torment, or
that he has received a direct command from God to do
certain things—such as to commit suicide, or to kill his
wife or one of his children,
Insanity is often shown by a perversion of seriptural
texts. Many a lunatic has mutilated himself by literally
acting under what he conceives to be a Divine command,
such as “ If thine eye offend thee, pluck it out.”
In many cases the patient shows his insanity by his
unnatural and morbid hatred to his wife or some of his
children, either under the delusion of his wife’s infidelity
or that his children are conspiring against or robbing
him,
These hallucinations occasionally lead to serious acts
of murderous violence; and, if clearly proved to be erea-
tions of a diseased imagination, justify restraint. In
numerous cases it is sufficient to certify that the
patient is labouring under general paralysis of the
insane, accompanied with great mental excitement ‘and
exaltation, and insane ideas of exalted rank and position.
Clearly manifested symptoms of softening of the brain,
Insanity
shown by
perversion
scriptural
texts.
Chronic
intemper-
ance will
not per se
justify a
certificate.
Difficulty of
dealing with
patients
with moral
insanity.
74 . MANUAL OF LUNACY
associated with imbecility and incoherent conversation,
are sufficient to justify a certificate; but no physical
disease or disordered conditions of the brain and ner-
vous system, even if associated with paralysis or con-
vulsive disorders, such as epilepsy, will warrant a
certificate of insanity, unless the patient shows symp-
toms of positive mental derangement, with or without
delusions. Acts of reckless extravagance, violent de-
portment, cruelty, brutality of conduct, or gross immo-
rality, are not by themselves sufficient to authorise a
certificate, unless it can be clearly established that these
states of mind are the effect of some disorder of the
brain deranging or impairing the intellect, and are likely
to incite to mischievous acts.
Chronic intemperance will not of itself be sufficient
to warrant a certificate, unless connected with some
symptoms of disease of the brain, or disorder of the
mind. The existence of what is termed “ moral in-
sanity” will not alone justify a certificate or the impo-
sition of legal restraint.
The moral sense is often morbidly perverted and
deranged. In many of these cases no actual mental
delusions are detected. This condition of mind is often
fraught with serious mischief to the patient and his
family, and such patients require control and treatment.
Persons so afflicted present great difficulties to the
medical man, when called upon to certify, for the pur-
pose of placing them under restraint. No certificate
would be justifiable unless there can be detected with
the so-called “moral insanity” a clearly manifested dis-
order of those powers of the mind which are involved
in the exercise of the judgment and reasoning faculties,
and which disorder is likely to impel the patient to the
commission of some insane and mischievous act to him-
self or family. The line of demarcation between vice
and insanity is most difficult to perceive or define,
PRIVATE PATIENTS 75
In conclusion, the medical men who sign the certifi-
cates must remember that only “ facts” observed on the
day of their ewamination of the patient are admissible.
“ Other Facts (if any) indicating Insanity communicated
to me by Others.”
In order for a certificate to be legal, the facts of
insanity observed by the medical men who sign must
be stated.
The. second part of the certificate has reference to
other facts communicated to the medical men by the
attendant of the patient, the relatives, or friends.- It is
always most desirable for the certificate to contain some
facts obtained from those who have been in immediate
attendance on the patient during his illness. Besides
strengthening the certificate, those who are to have the
charge of the patient will have these important facts for
their guidance in the management of the case.
At the time of the examination the patient may,
though labouring under delusion, be calm and quiet.
The friends of the patient may be enabled to tell the
medical men that at certain times the patient is very
noisy and excited, and will then, if not prevented,
destroy whatever comes.in his way. This is an im-
portant fact “communicated by others.’
“ His sister (Jane Wilson) informs me that he has
threatened several times to commit suicide.”’
“His brother (John Wilson) informs me that he
refuses his food, and that during the last few days he
has not eaten sufficient to support life.”
“His attendant (William Jennings) tells me that
the patient is very cunning, and will endeavour to con-
ceal anything with which he can do injury to himself,
and that last evening a knife was found concealed
underneath his pillow.”
The name of the informant must always be given.
Facts only
observed on
day of
examination
of the
patient are
admissible.
Other facts
of insanity.
Facts com-
municated
by others,
though not
compulsory,
in order for
the certifi-
cate to be
legal, are
notwith-
standing
very de-
sirable.
Examples
of “ other
facts.”
Instructions _
for filling ap
medical
certificates,
76 MANUAL OF LUNACY
The following instructions relating to the signing
of medical certificates were drawn up by Mr. Com-
missioner Phillips during the time he acted as Sec-
retary.
MEDICAL CERTIFICATES.
Instructions.
Every medical certificate must, in order to its validity, be
according to the subjoined form, prescribed by the “ Lunatics’ Care
and Treatment” and “ Lunatic Asylums” Acts, 1853.
In filling up the certificate the medical practitioner signing is re-
quested especially to observe the following essential particulars, viz.:—
1, After the words ‘‘being a” he is required to insert, not the
word “physician,” “surgeon,” or “apothecary,” but the legal
qualification, diploma, or licence entitling him to practise as such
within the United Kingdom.
The words of the interpretation clause are as follows :—“ ‘ Phy-
sician,’ ‘surgeon,’ or ‘apothecary’ shall respectively mean a phy-.
sician, surgeon, or apothecary, duly authorised or licensed to
practise as such by or as a member of some college, university,
company, or institution legally established and qualified to grant
such authority or licence in some part of the United Kingdom, or
having been in practice as an apothecary in England or Wales on
or before the 15th day of August, 1815, and being in actual prae-
tice as a physician, surgeon, or, apothecary, and registered under the
Medical Act.”
2, He is required to insert:—1. The date of examination. 2.
The place, with “the street and number of the house (if any), or
other like particulars,” where the patient was examined. 8, The
patient’s ordinary place of residence. 4. The patient’s profession
or occupation, if any.
8. In any case where more than one medical certificate is re-
quired by the Act he should insert before the words “ personally
examined” the words “separately from any other medical prac-
titioner.”
4. He is required, in order that his certificate may have any
validity in law, to set forth some fact or facts, or symptoms,
indicating insanity, observed by himself at date of examination.
5. The certificate need not be drawn up or dated on the day of
examination, but the patient must be examined within seven clear
days prior to admission.
6. Every certificate should be an independent and complete docu-
ment, and no reference should be made therein to another.
)
PRIVATE PATIENTS 77
7. In case of a private patient, the medical practitioners certifying
may not be in partnership, or in the position of principal and assistant.
Note.—Medical officers of unions or parishes are no longer pro-
hibited from signing certificates in the cases of pauper lunatics
belonging thereto,
Cuartes P. Prius,
Secretary.
Office of Commissioners in Lunacy.
The following table contains a complete list of all
metropolitan and provincial asylums in England and
Wales. By this will be seen the various towns in
which asylums are situated, the name of the asylum, to
whom licensed, the number of patients, whether male or
female, residing in the asylum, and the average number
resident during the previous year.
Metropolitan Licensed Houses.
Average num-
Number for || ber resident
which during the
Licensed year 1871
a ‘a
+ Town (|Nameof Housed To whom Licensed | M.| F.}] 8 || M.| F. s
* a
|Aeton + Parca Miss Benfield . «| —{| 12] 12/]—|. 5] 5
poe } [Bethnal House|Dr. John Millar -| 164] 246] 410]|| 129] 203] 332
[Brixton .|Effra Hall. Dr. W. H. Dia-
mond .
Mr. E. H. Byas, :
Bow . (Grove Hall . { surgeon,and Dr. + | 302}:150| 452/| 299) 115] 414
Mi :
‘| —| 26) 26) —] 20] 20
ickle . .
("3 C. A. Elliott,
Brompton .|Clarence Villa oe oe 2) — 2 2) — 2
‘Miss Buty and
Pe a RG saa —| 30] 30] —| 28) 28
A n Mrs.
Brook ) |Montague te ea
Green | "House ee Ss A 13 13|| 12 12
‘Camber- am berwe r. J. H. Paul an
well } House i} ee s Schofield a} 184] 269) 453]| 145) 236) 381
mtherlans
Chelsea . } Blacklands} |" and Mr. E. ial} 35} —| 35|| 16|—| 16
ouse = surgeon .
Elm House,! (yfy.7. A. B. Bon-
r { 149 Chureb (ea “f}—| 10 ao) —| 8} 8
Chiswick .{Manor House ./Dr. Tuke . 20) 20; 40]} 13) 13) 26
The Retreat| ( Mr.JohnBush, sort eae ee sl el 32
Clapham { UnionRoad* geon (deceased)
* This establishment is now closed.
Pauper and
private
patients.
Pauper and
private
patients.
Pauper and
private :
patients.
Pauper and
private
patients,
Private and
pauper
patients,
78
MANUAL OF LUNACY
METROPOLITAN LICENSED Hovuses—continued.
A verage num-
Number for |} ber resident
which during the
= Licensed year 1871
Town |Nameof House} To whom Licensed. | M.| F. 4 M./ F. 3
: Dr. H. Monro and
Clapton } [Brooke House|} J. O. Adams,+| 44) 46] 90|/ 40) 87] 77
Upper nariecns = oP
Dr. Blandfor
Munster 5 e
‘Fulham . Mr.J.F.Hemming, 35) — | 85]| 27, —| 27]
{ Houses } {ie CG. Williams |
- Nommand | \iss Talfourd . .)—| 15] 15) —| | 8
OttoHouse | |Mr. A.C. Sutherland
> eg | (vend Miss E. Dixon t|— | 85] 35/—| 32] a2
‘Hackney nena wear eee Ayre . . +} — | 15) 15) —] 12) 12
‘Hammer: ) |Upper Ma. = ae
ame J Boase af Mrs,Cotes. . 10} 10 5] 6
5 ussex al
Drs. F., H. F., and
Branden- % 42) 22) 64]; 36) 21) 57
” Branaen-| L, 8. Winslow . }
Ramee Normansfield .|Mrs. Down. . .| 25] 25] 50]] 19) 15] 34
Hanwell ./Lawn House .|Dr. H. Maudsley +} — |] 10} 10) — 6) 6
‘ Kent Lodge .|Mr.F. Waite . | 3) 2] 5i| 3| a 4
Vine Cot-
Ss he a Mr. and Mrs. Chalk |) — | 12) 12)/)/—| ly) 1
wood Green ,
Hayes .|Hayes Park is oe Mrs. Benbow) — | 19) 19|/ —]| 15} 15)
ir. H. Stilwell, Mr.
a ee J. Bite and ts. | ~| 19} 19] —] 18] 18
pence . . 7
Hendon de coe ne ee eee pea —1} 10) 10) — 8} 8
rey oorcro’ yy well ani
Hillingdon { House v H. Elliott, wall and) 46) — | 46) 45) —| 45
‘Hoxton ./Hoxton House|Dr. W. J. Hunt . -| 94) 231] 825|/ 84! 178] 257
‘Isleworth .| eee House .|Dr. E. S. Willett .| 25} “20) 45]/ 23] 15] 38
ensing- ||Dr. Wood and T,
Kensington {Roto | Bigland, maraese f 80) 33) 63) 17} 23) 40
Kilburn .|51 Priory Road] { “ago _ | 2 2
Leyton al eee Fiense -|Mrs. Davey . —| 15 15) —] 13) 18
Norwood ee tag 5 :
House,Nor-;} |Mrs. Foreman . | 4) I) 5 4) 1
Lower { (Besxnan
Peckham 4 { “xcase. }| Dee AnH Sicko [| 105] 226] a30]| 78| 154] 299
Silverton
Peckham :
House, Lin- } |Mrs. Fruin . . | — 8 —
a ‘aa ate) i 17
o ‘Dr.
Southall .| {Son biall} Dr StewardandMrs.}/ 5! yo! a7] 13) 11| 24
Pr Bout Ledee bee ae Mrs. Steward| — 4) 4/| — 3] 3
a out e .|Mr. arvey . + 2 2)} — 2} 2
Stoke ) |Northum-
Newse: | be rland/ (Dr. and Mrs. Sabben .| 40] 45! 85|| 36] 36] 72
ouse s
Halli
Sunbury .|{zonces {Dr Seaton. . | 19] 161 28] 9] 1a] 22
Twicken-) |Twickenh-) |Dr. H. W.
ham } ham Hows f ine — 1 14) 15 2 14 16
Totals . 1241/1631/2872] 1058 1289 2347)
* New licensees since Commissioners’ Report, 1872.
t Dr. Wood has transferred his patients to the Priory, Roehampton.
PRIVY.
ATE PATIENTS
‘Provincial Licensed Houses.
79
Average num-
woes Nymber for || ber resident
which during the
Licensed year 1871
a =
County Houses 'To whom Licensed.) M.| F. | 8 || M.| F. g
~ e ‘1A A
Beds, “Springfield House, ) |Dr. H. Harris.
| near Bedford | (Surg.) vt 20 | 20 | 40 || 10 | 11 | 22
Chester .|Hollingworth Hall,
i. saunant; Man-} |Mr. E. Rowlands .| 8] 2/10 |} 4| 2] 6
, | chester Sc
Derby «(Wye House, Buxton . i cae 24 | 20 | 44 | 15 | 17 | 32
|Devon -|Senton House,Kenton Miss + oe | -|] 6) 6] -} 2] 2
1- lympton ouse,| |Mr. 8. ang-
o Plympton . : ig eure) | 17] 17 | 84 |] 14) 9 | 23
Cee ten near } Dr.J.W. Eastwood] 28 | 22 | 50 || 21 | 13 | 34
» |Dunston Lodge,near | lyr. yw, Garbutt .| 80 | 25 | 55 || 97 | 14 | 41
/Hissex .\Essex Hall, near . f
! rae iiss pes .| 66 | 33 | 99 || 66 | 30 | 96
" in
| Witham. «=, f PEE. M-Tomkin }) 15 | 10 | 25 ]] 9 | 5 | 14
{Glamorgan ec House, meh hg ee Peeue | 80 | 80 |160|| 27 | 53 | go
(Gloncest prorehwoeds, near | Ip, J.G. Davey | 15 | 15 | 80) 7 | 10] 17
Fairford . House, ) |Messrs.D.D. and
te” Fairford 2 Tics sf] 85 | 85 | 70 |) 21 | 28 | 44
= The Cro ‘ouse 3 _
he” oi ays > | ors. Tes 4 4} 4 3] 3
as Sandywell Park,
Dowdeswell, near + |Dr.W.H.O.Sankey| 17 | 17 | 34 || 12 | 15 | 27
Cheltenham,
Tusculum ouse, ah ras
” Tae tee Powell 3] 3 2/2
ee a We ook House, | Mrs. B. J. Burnett | 25 | 25 | 50 || 14 | 15 | 29
Herts (Harpenden Hall
i "near St Albans aes G. Rumball} 7| 8] 10|/ 3] 1] 4
adham ace. 6
a Much Hadham s Eee pana | 12) 8 | 20 6} 4/10
. W. Harmer
peer of Nee rere SOG |) aad De. W. it} 16} s|24 jie! 6] 48
Harmer .
a |Tattlebury sue Mr. R. 8. Sa a| 4|e8 2) -| 2
oes on ington (Surg.)
est Malling Place,
» est Malting Place, | Ir, T. H. Lowry .| 18 | 14 | 82 |] 9 | 11 | 20
Lancaster ./Marsden Hall, Ee Eel Bare is 113} 28 || 12] 9 | a1
ur; ;
Clifton Hall, near) |Mrs. Lomas and
A Moma Mi;-D-H Lomas t| 25 | 15 | 30 |] 10 | 10 | 20
2 ee sets} Dr. E. Lister 105 | 145 | 250 || 101140 | 241
on, Newton- .E. i we
le- Willows . ,
a Tue Brook Villa,||Mr. H. Owen
aon ear 3 26 | 26 | 52 || 15 | 19 | 34
Pauper and
private —
patients.
Pauper and
private
patients.
v
Pauper and
private
patients.
Pauper and
private
patients.
80
MANUAL OF LUNACY
PROVINCIAL LICENSED Houses—continued.
* Patients removed to Colville House, Lower Norwood.
Averagenum-
Number for || ber resident
which during the
= Licensed || year 1871
__}
a =
County Houses |To whom Licensed) M.| F. 3 j| M. | F. é
ie nc WE Neo
Nerfo! -|Heigham an r. J. F.
near Sean cae ee | 35 | 35 10 31 | 31 | @
geons) . |
The Grove, Catton, ) |Mr.T. J.C. Rack- 1
a near Norwich : ham . “} 11 | 18 4] 9} 9) 18
Northamp-|Abington Abbey .
ton Heireat, wee ‘Dr. Thos. Prichard] 24 | 17 | 41 || 18 | 16 | 34
orthampton . 4
Shropshire [Stretton _ House, |! w. Hyslop | 40| -| 40 || 33) ~| 88
» Grove House, All} Iytrs, Bakewell | - | 45 | 45 || - | 81 | st
Somerset ee er ve = a et 56 | 50 }106|| 52 | 38 | 90
near Bris a .H. Fox.
» |ongwood | House, } pr. @. Rogers | 30 | 20 | 50 || 26 | 16 | 42
Bailbrook House.
” EEE ton” | [Mr J- Terry(Surg.)| 20 | 20 | 40 || 15 | 10 | 25
” ‘Upper House, '
aoe Down, } |Miss B. Long | 5] 51) 10 4) 38) 7
Bath . .
i Po House, hee aoe bisa -~|20]20l] -| 16 | 16
near Taunton ‘or’ so
» Downside Lodge, } lwries M. Short | -| 7] 7]/ ~| 5] 5
Stafford .|Moat House, Ten} Mr. J. F. Woody ~1}10 10 -|3{3
worth (Surg.) .
a ‘Barr House, Great
th near Bir-}|Mrs. Moore . | -| 10/10 ]) -| 6] 6
mingham .
Suffolk +jAspall oS neat} eee J. Che- 5} sliill 4] 2] 6
ebenham . vallier . .
5s The Grove, Ipswich .|Dr. B. Chevallier .| 8 | 2 | 10 6 6
” moa House, | MissS.A.F.Walter| 3| 5| 8 || 2 5
Surrey oes Ee era es T. ep Sells s| -| 8 ah =) 6
uildford . urg.-) .
5) Church Street, Epsom ee eet -j10}]10]] -| 8} 8
a Dr. Samuel ”
Sussex .|Ticehurst Asylum | { PE a } 44 | 30 | 74 |) 41 | 24 | 65
vs Church Hill House, >} Mrs. F
Brighton * . rs. Foreman .| -| -| -]| -| -| -
” St.George’s Retreat,
Ditchling, Burgess (Miss Eccles, &c. .| 10 | 24 | 34 |} 2/11 | 18
Warwick .|Drifiold House, Sut- } ipr.G.F, Bodington| 12 | 18 | 80 |) 7 | 12 | 19
3 ee wee Weare 17/13} 30l)14| 7/21
enley in Arden le . ‘ar .
ee [Arden House, Be: Mr. G.R.Dartnell ala t
ley in Arden (Surg.) . " 6 Loy at
PRIVATE PATIENTS
PROVINCIAL LICENSED Hovses—continued.
81
i Average num-
j es Number for ber resident
which, during the’
Licensed year 1871
T ie 6 wk . —_
‘County Houses To whom Licensed| M. | F. 8 M.| F. g
‘A A
Warwick .|{Hurst House, Hen- nas i
vey in Arden ; } {ars Phittips . -| -| 8} 8] -| a] 3
roy idlan ounties ) [p. 1.B. E. Flet-
Idiot Asylum. ely at
Dorridge ae ene urs | 8 | 12 | 20 6 | 10 | 16
Knowle Common ee : .
< r. J. Haynes
[wits — |Laverstock | House, | |"'¢ wr, H.Man- + | 35 | 86 | 70 || 24 | 27 | 51
near Salisbury ning (Surg.)
Mr. W. C. Finch
4 oo» |Fisherton rows (Sur.) and Dr. | | 338| 278 | 616 || 183 | 191 | 374
+ near Salisbury J.A.Lush,M.P, 1°
i Fiddington House
q a | Market raving} Dr. C. Hitchcock .| 20 | 20 | 40 || 15 | 13 | 28
ton, Devizes !
» Ringsdown House, 'py, Jos, Nash | 17 | 28] 40 |] 16 | 22 | 88
Mr. F. J. Ben- |
Worcester .|Droitwich Asylum . -| -| -]} 8] 6] 14
York, E.R.|Marfleet Lane Re- { neti Gurg).}
treat, Sculeostes, rye, J, Brown | - | 11 | 11 || ~ | 10 | 10
Dunnington House
” pine ey Mr. BR. H. Hornby | 24 | 16 | 40 |] 21 | 13 | 34
Meas NB. errece eae O) ire Uae ig af SHYT | |
aldwick . :
York, W.R. ioe Stead, near ) |Dr.G. P. Smith
Ik, beens. Seatn | 15 | 15 | 80 |} 9 | 12 | 20
larete Bank, "Bar.
” |" noldswick, ear J.Parker .| 5| 6] 10]) 3| 2] 5
pene .
® rove ouse
” Acomb, near York (Mr. Robt. Pearson.| 14 | 17 | 31 |) 13 af 26
(Lime-tree ouse, eh @
” cectnb near York f (M+ Samuel Nelson] 12 | 6 | 18 | 4
” 'The Grange, Kimber- 7 :
worth, Rotherham,| | Dr. J. G. Atkin-| _| yo] 42 |] -| 7| 7
! ie a a Bon. » « a
‘ ‘ouse ce aia 3 ‘
York City .|Lawrence House, York Mr, W.Pumphrey.| 4] 8 | 12 4! 5) 9
Totals S |1422|1407/2829]| 993 |1015)2008)
Pauper and
private
patients.
Pauper and
private
patients.
Pauper and
private
. patients,
It is illegal
to take
charge of,
for profit,
a, person of
unsound
mind with-
out first
obtaining
the neces-
sary docu-
ments.
Single
Patients.
82 MANUAL OF LUNACY
CHAPTER VI.
SINGLE PATIENTS CONFINED IN UNLICENSED PRIVATE HOUSES.
No person, except a Committee appointed by the Lord
Chancellor, who derives profit from the charge of
a lunatic, can receive him into his house without an
order, statement, and. medical certificates, similar to
those required previous to the admission of a patient
into an asylum.
The number of private patients under single care,
in pursuance of the 90th section of the Act 8 and 9 Vict.
c. 100, on Jan 1, 1872, was 420, and the changes which
have taken place in the past year are shown in the
following table, taken from the Commissioners’. last
report :—
Males. | Females.| Total.
Wunteton Jamey, tet 2 «| fe | gee | 9a
Registered during the year . . 79 109
= 239 | 341
Discharged anddied. . « °- 7 =| ~=«89
Re- {Not Re-
covered.|covered.| Died.| Total.
Males. . 6 49 }16] 71
Females ,| 13 66 10 89 :
19 115 | 26 | 160
Remaining, January 1,1872 . «| 168 252 420
Of whom found lunatic by inquisition
and not visited by the Commissioners 57 64 121
+
SINGLE PATIENTS 83
Ifa person is desirous to place any relative alleged
to be insane under care and treatment, and has arranged
for some one to admit him into his house, it is advisable
for the person who is about to receive the patient to
call at the office of the Commissioners in Lunacy,* and
obtain from the Secretary copies of the necessary legal
documents, which have to be properly filled up before
the patient can be received.
The order and statement can be signed by the father
or any other relative or friend of the patient who is
authorised to act.
The order is addressed either to the person receiving
the patient as “proprietor,” or to the attendant under
whose charge the patient is, as “ swperintendent.”’
The patient will have to be examined by two medical,
men, who will sign the certificates.
Legal authority is now given to the proprietor or
superintendent to receive the patient into his house
within seven days from the date of the certificates.
He is required to transmit to the Commissioners in
Lunacy an accurate copy of the order, statement, and
certificates within twenty-four hours from the reception
of the patient into his house.
The person selected to act in the capacity of medical
attendant (who is appointed either by the person sign-
ing the order for the patient’s admission or by the pro-
prietor of the house or lodgings) must send to the office
- of the Commissioners a statement respecting the bodily
health and mental state of the patient, and regularly
visit him, and make the proper entries in the ‘‘ Medical
Visitation Book” + (as required by Act of Parliament)
at least once a fortnight.
The examination for the statement must be made
* 19 Whitehall Place, 8.W.
{ This book, as well as all official documents, can be obtained at
Shaw & Sons’, Fetter Lane; and Knight & Co’s., 90 Fleet Street.
@ 2
Proceedings
prior to the
‘reception
of an insane
person into
a private
house.
Order.
Medical
Certificates,
Copies of
legal docu-
ments sent
to Com-
missioners.
Medical
Attendant.
Statement.
Single
patients
visited by
Commis-
sioners.
No licence
is required
for one
patient.
Order and
Certificates.
8 & 9 Vic.
c. 100, s. 90,
and 16 & 17
Vic. c. 96,
ss. 4, 8.
Copies, &c.,
to be sent
to Com-
missioner3,
25 & 26 Vic.
c. 111, s. 28,
84 MANUAL OF LUNACY
after the expiration of two, and before the expiration of
seven clear days from the patient’s reception, and can
be sent to the Commissioners any time within that
period. :
All single patients are visited at least once a year
by one or more of the Commissioners.
Single Chancery patients are visited four times a
year by the Chancery visitors.
No licence is required for one patient, but if more
than one is confined in the house the proprietor must
have a licence, and the house becomes for the time
being an asylum, and subject to the same rules and
regulations.
I have thought it advisable to give the regulations
referring to single patients as laid dowh by the Com-
missioners in Lunacy in the appendix of their seven-
teenth Report. By this it will be clearly seen what is
required from all who undertake the responsibility of
admitting single patients in their houses for profit.
TO ALL PERSONS HAVING CHARGE OF SINGLE
INSANE PATIENTS.
The Law relating to Single Insane Patients, and defiming the duties
and responsibilities of those who undertake to receive such Patients
to reside with them, being in general very imperfectly understood,
and frequently violated, your attention is urgently requested to
the subjoined statement of the various provisions of the Statutes,
which the Commissioners intend, in future, most strictly to
enforce. ‘
Provisions or THE Law as To Sinere Patients.
No person deriving profit from the charge can receive into any
house, or take care or charge of, a patient, as a lunatic, or alleged
lunatic, without an order, and two medical certificates.
Within one clear day after receiying a patient, true copies of the
order and certificates, together with a statement of the date of
‘reception, and of the situation and designation of the house into
which the patient has been received, as well as of the Christian and
surname of the owner or occupier thereof, must be forwarded to
the Office of the Commissioners in Lunacy, No. 19, Whitehall Place,
London, 8.W. :
SINGLE PATIENTS 85
In addition to these documents, there must now be forwarded
to the office of the Commissioners a statement of the condition of
the patient, signed by his medical attendant, after two clear days
and before the expiration of seven clear days from the day of
reception, according to the form in Schedule F to chapter 100.
The order and certificates must not be signed by any person
receiving a percentage on or otherwise interested in the payments
for the patient, nor by the medical attendant, as defined by the
Lunacy Act, chapter 100; nor must the certificates be signed by the
father, brother, son, partner, or assistant of the person having the
care or charge of the patient.
The patient must be visited, at least once in two weeks, by a
physician, surgeoh, or apothecary who did not sign either of the
certificates of insanity, and who derives no profit, and who is not a
partner, father, son, or brother of any person deriving profit, from
the care or charge of the patient.
Such medical man must at each visit enter in a book to be kept
at the house, according to the subjoined form, and to be called the
“Medical Visitation Book,’ a statement of the condition of the
patient’s health, both mental and bodily, and also of the condition
of the house.
‘These visits may, by special permission of the Commissioners,
be made less frequently than once in every two weeks; but in such
case, where the patient is under the care or charge of a medical
man, such medical man must himself make an entry once at the
least in every two weeks in a book to be called the “Medical
Journal.”
Every physician, surgeon, or apothecary who visits a single
patient, or under whose care a single patient may be, must, on the
i0th of January, or within seven days thereof, in every year,
report in writing to the Commissioners the state of health, mental
and bodily, of the patient, and such other circumstanees as he may
deem necessary to be communicated. Each annual report should
give all these particulars fully, even although no change may have
occurred since the previous report.
Statement.
25 & 26 Vic.
e 111, 5, 41.
Persons
disqualified
from
signing.
25 & 26 Vic.
e. 111, 8. 24,
16 & 17 Vic.
¢c, 9, 8, 12.
Fortnightly
visits.
8 & 9 Vic.
ce. 100, 8. 90.
Entries.
Less fre-
quent visits.
16 & 17 Vic.
c, 96, 8. 14.”
Annual
Reports.
16 & 17 Vic.
c. 96, s. 16.
. ee ” “ i “ Medical Visitation
“The Medical Visitation Book” and ‘ Medical Book,” hie. 8 & 9 Vic.
Journal,” and the order and certificates, must be so kept oc, 100,s, 90, and 16 &
that they may be accessible to the Commissioners when-
ever they may visit the patient.
17 Vie. c. 96,5. 14.
‘i : - Notices. 8 & 9 Vic.
Notice must be forwarded to the Office of the Com: ©. 100, 88.53, 54,55 and 90.
missioners in case of the death, discharge, removal, escape Continued and extended.
and re-capture of a patient.
Notice of the death of the patient must also be forwarded to the
Coroner of the district.
16 & 17 Vic. c. 96, s, 21-22.
25 & 26 Vic.
ce. 111, s, 44.
Transfers,
16 & 17 Vic.
c. 96, 8, 20.
Changes of
Residence.
16 & 17 Vic.
¢c, 96, 8. 22.
Removals
for Health.
Penalties
for neglect
or violation
of the law.
8 & 9 Vic.
ce. 100, s. 90.
86 MANUAL OF LUNACY
If it is proposed to remove the patient to the care or charge of
another person, the consent to an order of transfer must previously
be obtained from the Commissioners, otherwise a fresh order and
’ certificates will be necessary.
When any person having the care of a single patient proposes
to change his residence, and remove the patient to such new resi-
dence, seven clear days’ notice of the proposed change, with the
exact address and designation of the new residence, must be sent
to the Commissioners, and to the person who signed the order. for
reception of the patient. :
If it should be desired to give the patient liberty of absence
anywhere, for a definite time, for improvement of his health, or for
a trial of his powers of self-control, the consent of the Commis-
sioners must first be obtained; the written consent of the person
who signed the order must accompany the application, as well as a
statement by the medical attendant showing the fitness of the patient
for such trial.
The attention of every person having charge of a single patient
is specially drawn to the concluding paragraphs of the 90th section
of the 8 and 9 Vict. cap. 100, by which he will see that if he shall
receive a patient without a proper order and certificates; or if,
having such certificates, he neglect to transmit copies to the Com-
missioners in Lunacy; or if he fail to cause such patient to be
visited fortnightly by a medical man (not disqualified as above); or
if he make any untrue entry in the ‘‘ Medical Visitation Book,” he
shall be guilty of a misdemeanour.
N.B.—A licence for the house becomes necessary only where
more than one patient is received.
FORM OF MEDICAL VISITATION BOOK, OR
MEDICAL JOURNAL.
' patie wealth oe or Seclusion] State of
ly Hea: since last entry. s House.
Date. Leepeelly and When and how long ? ee Bed, and
‘! Condition. | By what means, and |""" 8+) Bedding,
for what reasons ? &e.
SINGLE PATIENTS 87
FORM OF NOTICE OF DEATH.
I hereby give you' Notice, That
a Private Patient, received into this house on the
day of 18___, died therein on the
day of 187___; and I further certify, that
_ sas present at the death of the said
and that the apparent cause of
death of the said (*)
was
Signed,
(t)
Dated this day of One
Thousand Eight Hundred and Seventy
To the Commissioners in Lunacy.
(*) Ascertained by post-mortem examination, if so.
(t) Medical proprietor of house, or medical attendant.
FORM OF NOTICE OF DISCHARGE.
L hereby give you Notice, That.
a Private Patient, received into this house on the
day of. 18___, was discharged therefrom (*)
by the authority of
on the day of 187
Signed, 2
(t)
Dated this day of One
Thousand Eight Hundred and Seventy.
To the Commissioners in Lunacy.
(*) Recovered, or relieved, or not improved.
(+) Proprietor of house.
The Commissioners in Lunacy are constantly en-
forcing compliance with the law relating to single insane
Remarks by
Commis-
sioners on
single
patients.
88 MANUAL OF LUNACY
patients, and the following remarks, taken from their
twenty-fifth Report, clearly show the necessity of strictly
complying with the law: “We have during the past
year continued to use all available means to promul-
gate and enforce compliance with the law applicable
‘to the insane under single private care, and have
availed ourselves of all sources of information with a
view to discover cases of violation of its provisions.
The result has been to extend to a considerable num-
‘ber under illegal charge (some of whom were greatly
neglected) the benefits of proper medical supervision
and treatment,
In some cases the information upon which we acted
was communicated to us voluntarily by the persons
having charge of the patients, who, influenced by
fears of prosecution, pleading ignorance, and desiring
instructions, thus disclosed the facts.
In such cases we have had to consider whether,
regard being had to all the circumstances, including the
position in life of the parties implicated, the plea of
ignorance could properly be entertained.
Whenever after due enquiry we saw good reason to
be satisfied upon the points, we have simply required
an immediate compliance with the Lunacy Acts by
placing the patients under certificates, and providing
for their future medical visitation and care.
In several other cases we have imposed, as a condi-
-tion for foregoing prosecution, a public apology in the
London and provincial papers and medical periodicals.
The publication of such apologies being much
dreaded, we have been strongly appealed to not to insist
upon them, but to such appeals we have never yielded.
We never adopt.this intermediate and lenient course
without very careful consideration, nor have we applied
‘it in any case which essentially, in our judgment, called
for criminal proceedings and punishment.
SINGLE PATIENTS 89
We have always borne in mind the encouragement
it might give to wilful offenders.”
The Commissioners in Lunacy having had frequent
occasion to consider the legal construction of the
90th section of the 8th and 9th Vict. c. 100, which
refers to single patients, thought it desirable in 1870 to
submit a case for the law officers of the Crown, through
the Home Secretary.
Case and Opinion on Construction of 90th Section of
8th and 9th Vict. c. 100.*
Counsel are requested to consider the letter. and
spirit of the stringent statutory provisions for the re-
ception or charge of the insane, and especially the
language of the 90th Section of the Act 8th and 9th
Vict. c. 100, and to advise the Commissioners in
Lunacy upon the following points :—
QUESTION.
1. Is the word “profit” in
that section to be read as syno-
nymous with “payment?” If
not, how is that word to be con-
strued ?
2. Is receiving “to board or
lodge” in that section to be read
as a proceeding distinct’ from
taking the “ care or charge” of a
Innatic? If so, where a lunatie
is received to board or lodge in
the house of one person, and
another takes the “care or
charge” of him, by which per-
son should the statutory docu-
ments be obtained ; and are both
punishable for neglect in obtain-
ANSWER.
1. We are of opinion that
“payment” is not absolutely
synonymous with “profit.” Pro-
fit is the larger term, and may
include other advantages be-
sides pecuniary.
2. We are of opinion that
receiving to board or lodge must
be read as distinct from taking
care or charge. The duty in
question is imposed by the sta-
tute on both, and both are pun-
ishable if they neglect it.
* Appendix N, Commissioners’ Report, 1870.
Opinion of
Counsel
taken on
certain
statutory
provisions
relative to
single
patients.
90 MANUAL OF LUNACY
QUESTION.
ing the same, and supplying co-
pies to the Commissioners ?
8. What is the full force and
meaning of the words in the 90th
section, “as a lunatic or alleged
lunatic,” and by whom must the
lunatic be alleged to be so?
4. If a wife become lunatic,
and be removed by her husband
from home to a house elsewhere
taken for her exclusive accom-
modation, and she be there
placed in the charge of a resi-
dent medical man or paid at-
tendant, are an order and certi-
ficates under the 90th section
requisite for her reception or
charge; and if so, to whom
should the order of reception be
addressed ?
5. Is the last question af-
fected, and in what way, by the
fact that the house to which the
lunatic is so removed is not a
house specially hired for the
lunatic, but the property or for-
mer residence of the husband ?
6. Does the residence in that
house of the husband, or of any
and what number of the pa-
tient’s family, affect, and in what
way, that question? Are occa-
sional visits to the wife there, by
ANSWER,
8. We think the words “lu-
natic or alleged lunatic” are
used for the purpose of ensuring
the protection of the law not
only to lunatics in fact, but to
all persons who, without being
lunatics, are treated as lunatics.
No one in particular need “ al-
lege” the person to be a lunatic
for the purposes of s. 90. “It is
enough if the person is received,
or taken charge of, as being, or
as being represented to be a
lunatic.
4, In the case of a husband,
he will very seldom be within s.
90 at all, because he very sel-
dom derives any profit from the
charge. Inthe case supposed,
the resident medical man is,
however, we think, bound to
have the order and certificates,
and to transmit them under s. 90.
5. No:
6. We think the residence of -
the husband in the house would
render any order or certificates
unnecessary, if he, in fact, took
the care and charge of his own
wife, without placing her under
SINGLE PATIENTS 91
: QUESTION. .
the husband or relative, tanta-
mount to residence by him ?
7. Is an insane person re-
maining at home and alone, in
consequence of having no rela-
tions, but placed in the charge
of a resident medical man or
attendant paid for his services,
subject to the provisions of the
Act 8 and 9 Vict. c. 100?
8. Is the case of. a lunatic
husband, or any other and what
lunatic member of a family, dealt
with, as stated in query 4, by
his wife, or any and what near.
relative, equally within the pro-
visions of the Act 8 and 9 Vict.
c. 100, as that of a wife ?
9, Can a person sign an order
of reception under the Act ex-
pressly as an agent, and can he
‘thereby avoid individual respon-
sibility in the proceeding save to
his principal ?
10. If a husband deny the
lunacy of his wife, may another,
being the husband’s solicitor, or
styling himself to be so, sign an
order for her reception under the
Act as a lunatic?
11. If the copy of an order
signed by the solicitor, and so
described at the foot of the
order, be sent to the Commis-
ANSWER.
the care or charge of any one
else ; otherwise it would not af-
fect the question. Occasional
visits by the husband or other
relation would not, in our
opinion, amount to residence, or
to taking care and charge.
7. We are of opinion that
this question must be answered
in the affirmative,
8. We give the same answer
to this question.
9. Wethink not. The order
is to be “under the hand” of
some person; and the signing
person seems to us, therefore, to
be a principal, and cannot sign
as agent for another.
10. We think he may, and
that such order would primd
facie be good, if it purported to
be made by the solicitor acting
for himself, and not as attorney
or agent for another person. The
matter of fact would, in regular
course, if disputed, come to be
tried.
11. If the order purported to
be signed by the solicitor, gua
solicitor or agent, it would be
invalid; if on his own behalf,
Persons
guilty of any
infringement
of the law
relating to
single
patients are
liable to
criminal
indictment,
Opinion
expressed by
Lord
Shaftesbury
on the
subject of
“single
patients,”
92 MANUAL OF LUNACY
QUESTION. - 4 ANSWER.
sioners, what is their proper and the statutory forms were
course ? complied with, it should be dealt
with by the Commissioners as a
valid order. The peculiar cir-
cumstances would, of course,
suggest the strictest possible
enquiry.
(Signed) R. P. Corzmr,.
Temple, April 25, 1870. J.D. Corzrmer.
All persons violating the provisions of the law
enacted respecting single patients, are liable to an
action for misdemeanour.
With regard to the advisability of recommending
the confinement of single patients at their own residence
or in unlicensed houses, in preference to sending them
to an asylum, there is a diversity of opinion, but into
the consideration of this subject I do not propose +o
enter. I would, however, en passant refer to the views
of the Earl of Shaftesbury on this vexed point, as ex-
pressed by his lordship when examined in 1859 before
the Committee of the House of Commons.
In reply to the question, asked by the Chairman
of the Committee, “You do not know how many
houses there are with single patients?” Lord
Shaftesbury said: ‘““We* have no sufficient knowledge
of that, and we have spent years and years in en-
deavouring to learn it. I am certain that there are
hundreds of persons called single patients of whom we
have no knowledge whatever; and during the early
periods of legislation single patients were hardly ever
mentioned. By Act of Parliament no one was com-
pelled to send a record to the Secretary unless a
patient was under his charge eleven months; and we
found this to be the consequence, that they kept a
* Le., the Commissioners in Lunacy.
SINGLE PATIENTS 93
patient under their charge for ten months or so, and
- then shifted him to another house.”
“Do you think the single system an advantageous
one for patients P’’—‘ No, it is in many instances the
very worst, and from the bottom of my heart I would
advise anybody, if it should please Providence to afflict
any member of his family, to send him or her to a pri-
vate asylum; for if my own wife or daughter were
so afflicted, and if I could not keep her in my own
house under my own eye, I would send her to a private
asylum—to a good private asylum, because there are
most remarkable examples of excellence and comfort
among them. So long as a patient is kept within the
walls of his own house, under the care of his wife; or,
if it be a wife, under the charge of her husband, I do
not think that public opinion is ripe for allowing any-
one to go into it. If relatives choose to take charge of
patients themselves, they are right, if it is necessary for
their own happiness and comfort; but if they put them
under the charge of another, then I think the law has a
' right to see that there is no undue power exercised over
the-personal liberty and comfort of the sufferer.”
Definition of
“ Pauper.”
Preliminary
steps pre-
vious to the
admission
of a pauper
lunatic,
Notice in
writing is
to be given
by medical
officer of the
parish to the
relieving
officer if a
lunatic is
resident in
the parish.
This is
required to
be done
within
three days
from _receiv-
ing the
information,
94 MANUAL OF LUNACY
CHAPTER VII.
PAUPER LUNATICS.
1. In County and Borough Asylums.
2. In Licensed Houses.
3. In Workhouses.
Having considered in detail the course to be pursued
in dealing with private, I next proceed to a consideration
of pauper lunatics.
A pauper lunatic is thus defined by the Act:—“ Every
person maintained wholly, or in part, at the expense of
any parish, union, county or borough.”
Previously to placing a patient in a county asylum
information must be given to the medical officer of the
parish or union in which the Iunatic resides ; the sub-
sequent proceedings are as follows :—
*“Bvery medical officer of a parish or union who
shall have knowledge that any pauper resident in such
parish, or in any parish within the district of such
medical officer, is, or is deemed to be a lunatic, and a
proper person to be sent to an asylum, shall, within
three days after obtaining such knowledge, give notice}
thereof in writing to a relieving officer of such parish,
or if there is no relieving officer, then to one of the over-
seers of such parish, and every relieving officer of any
parish within a union or under a board of guardians, and
every overseer of a parish of which there is no relieving
officer, who shall have knowledge, either by such notice
¥* 16 and 17 Vict. ¢. 97, s. 67.
¢ All forms and orders referred to in this chapter will be found
at the end of the book.
PAUPER LUNATICS - 95
or otherwise, that any pauper resident in such parish is
or is deemed to be a lunatic (and a proper person to be
sent to an asylum), shall within three days after obtaining
such knowledge give notice thereof to some justice of
the county or borough within which such parish is situ-
ate; and thereupon the said justice shall, by an order
under his hand and seal, require such relieving officer or
overseer to bring such pauper before him or some other
justice of the said county: or borough, at such time and
place, within three days from the time of such notice
being given to such justice, as shall be appointed by the
said order ; and the said justice before whom such pau-
per shall be brought, shall call to his assistance a physi-
cian, surgeon, or apothecary, and examine such person ;
and if such physician, surgeon, or apothecary shall sign
a certificate with respect to such pauper, according to
the form in schedule (F) No. 3, to this Act annexed, and
such justice be satisfied, upon view or personal exami-
nation of such pauper, or other proof, that such pauper
is a lunatic, and a proper person to be taken charge of
and detained under care and treatment, he shall, by an
order under his hand, according to the form in the said
schedule (F) No. 1, to this Act annexed, direct such
pauper to be received into such asylum, as hereinafter
mentioned, or, where hereinafter authorised in this be-
half, into some hospital registered or some house duly
licensed for the reception of lunatics, and such relieving
officer or overseer shall immediately convey or cause the
said lunatic to be conveyed to such asylum, hospital, or
house, and such lunatic shall be received and detained
therein : provided always, that it shall be lawful for any
justice, upon notice being given to him as aforesaid, or
upon his own knowledge, without any such notice as
aforesaid, to examine any pauper deemed to be lunatic,
at his own abode or elsewhere, and to proceed in all re-
spects as if such pauper were brought before him in
é
Justice
orders the
lunatic to
be brought
before him.
96 MANDAL OF LUNACY
pursuance of an order for that purpose ; provided also,
that in case any pauper deemed to be lunatic cannot, on
account of his health or other cause, be conveniently
taken before any justice, such pauper may be examined
at his own abode or elsewhere by an officiating clergy-
man of the parish in which he is resident, together with
a relieving officer, or, if there be no relieving officer, an
overseer of such parish ; and such officiating clergyman,
together with such relieving officer or overseer, shall call
to their assistance a physician, surgeon, or apothecary ;-. .
and if such physician, surgeon, or apothecary shall sign
a certificate with respect to such pauper, according to the
said form in the said schedule (F) No. 3, and if, upon
view or examination of such pauper, such officiating
clergyman and such relieving officer or overseer be satis-
fied that such pauper is a lunatic, and a proper person
to be taken charge of and detained under proper care
and treatment, such officiating clergyman, together with
such overseer or relieving officer, shall, by an order under
their hands, according to the said form in the said
schedule (F) No. 1, direct such pauper to be received
into such asylum as hereinafter mentioned, or, where
hereinafter authorised in this behalf, into some such
registered hospital or licensed house as aforesaid, and
such relieving officer or overseer shall immediately con-
vey or cause such pauper to be conveyed to such asylum,
hospital, or house, and such pauper shall be received and
detained therein ; provided also, that if the physician,
surgeon, or apothecary, by whom any such pauper shall
be examined, shall certify in writing that he is not in a
fit state to be removed, his removal shall be suspended
until the same or some other physician, surgeon, or
apothecary shall certify in writing that he is fit to be
removed; and every such physician, surgeon, and apothe-
cary is required to give such last-mentioned certificate
as soon as in his judgment it ought to be given ; pro-
PAUPER LUNATICS 97
vided also, that where a certificate in the form in the
said schedule (F) No. 3, is signed by the medical officer
of the parish or union in which the pauper named
therein is resident, as well as by some other person, being
a physician, surgeon, or apothecary, called to the assist-
ance of the justice or clergyman and overseer or reliev-
ing officer, as hereinafter mentioned, such joint certificate
or such two certificates [as the case may be] shall be
received by the justice or clergyman and overseer or
relieving officer by whom such person is examined, as
hereinbefore mentioned, as conclusive evidence that the
person named. therein is a lunatic, and a proper person
to be taken charge of and detained under care and treat-
ment, and he or they shall make an order in the form in
the said schedule (F) No. 1, accordingly.”
I give below a short summary of the chief sections
of the Act referring to pauper patients :—
1st. The medical officer of a district must under
a penalty of 101. give within three days from his receiv-
ing information written notice to the relieving officer, or,
if there be no relieving officer, to the overseers, if there
is any pauper lunatic resident in his parish, and deemed
to be a proper person to be sent to an asylum.
Qnd. The relieving officer or the overseers, as the
case may be, must within three clear days from his re-
ceiving information give notice thereof to some justice of
the county or borough, who will thereupon deal with
the case.
8rd. In the event of the pauper patient not being
able to be conveniently taken before a justice, an offici-
ating clergyman of the parish (in priest’s orders), in
conjunction with the relieving officer or overseers, as
the case may be, may examine him, and, if satisfied as
to his state of mind, sign the order for his admission into
the asylum.
Ath. The justice upon receiving notice from the
H
Notice given
by medical
officer to
relieving
officer that
a lunatic is
resident in
his parish.
Notice given
by relieving
officer to ~
the justice.
The lunatic
can be
examined
by the
clergyman
of his parish,
who, if
satisfied,
may sign
the order
for his
admission
into an
asylum.
Justice
orders
lunatic to
be brought
before him.
In the
examination
of the
lunatic the
justice may
have the
. assistance
‘of a medical
man.
‘One certifi-
cate only is
required,
provided the
justice is
satisfied
himself ag
to the
insanity.
Relieving
officer,
except under
special cir-
cumstances,
must cause
the lunatic
to be taken
to an asylum
immedi-
ately.
Patient
may be first
taken to
workhouse.
The lunatic
must be
taken to the
County or
eoronen
asylum of
the parish
or place
from which
he has
been sent,
except under
98 MANUAL OF LUNACY
relieving officer (or overseer) orders the pauper patient
to be brought before him, or before some other justice
within three days
If the patient is unable to be brought before him,
or if the justice or officiating clergyman prefers it, he
can visit the patient at his own home or wherever he
may be, and examine him there. The justice during
the examination of the patient can have the assistance
of a medical man.
5th. One medical certificate filled up in the ordinary
way is sufficient for the reception of the patient into
the asylum, accompanied by an order. This is, pro.
vided the justice himself is satisfied that the person is
of unsound mind.
On the other hand, supposing the justice is not con-
vinced of the person’s insanity, and refuses to give an
order for the admission, he can be compelled to do
so if two medical certificates are given, the one signed
by the medical man called in by the justice, and who
examined the patient. with the justice, and the other
signed by the medical officer of the parish.
The relieving officer is required under a penalty to
convey the patient, or cause him to be taken imme-
diately to an asylum (or other establishment), unless
the medical man who examined him certifies that he is
in an unfit state for removal; in which case the removal
is postponed until he is well enough to be removed.
6th. If the patient cannot be brought forthwith to
the asylum, he can be taken to the workhouse.*
7th. The lunatic must be taken to the county or
borough asylum connected with the parish or place
from which he is sent, unless, in consequence of defi-
ciency of room or other special circumstances, he cannot
be received therein. %
If he is unable to be admitted into the county or
* 25 and 26 Vict. c. 111, 8. 20.
PAUPER LUNATICS 99
borough asylum, or if there be no county or borough
asylum, then the law does not prohibit him from being
admitted into any other asylum in which pauper lunatics
are received ; but the special circumstances, &c., which
have prevented him from being received into his own
county asylum must be clearly stated in the order ;
for instance, “ Deficiency of room,” “No asylum in his
own county,” &c. It must also be stated that the
justices are satisfied with this arrangement; but no
pauper can be received into an asylum without the
proper order, statement, and certificate, and these will
authorise his detention in the asylum until he is duly
removed or discharged.
Pauper patients are permitted to go on leave of
absence for a stated time, permission being granted by
any two of the visitors of the asylum, the medical officer
first advising the proceeding in writing.
In the event of the patient not returning within the
stated time he can be recaptured and brought baek
within fourteen days.
The discharge of a pauper patient rests with the visi-
tors of the asylum. The medical officer of the asylum
having first given his advice in the matter in writing, any
two of the visitors can authorise the discharge, and any
three of them can do so without obtaining the advice
of the medical officer.
The relatives or friends of a pauper patient can re-
ceive the patient home, provided they give a satisfactory
guarantee to the visitors that the patient will be no
longer chargeable to any parish, union, or county, and
shall be properly looked after and taken care of, and:
prevented from doing i injury to himself or others,
A pauper patient dying in the asylum is buried at
the expense of the union, parish, or county to which
the deceased pauper is chargeable.
Any person wishing to obtain information concern-
H 2
special
circum-
stances.
Leave of
absence.
Visitors of
asylums can
authorise
the patient’s
discharge,
The relatives
can receive
the pauper
home.
Death and
expenses of
burial,
Pauper
dunatics can
be received
into licensed
houses on
one medical
aertificate,
Guardians
-of the parish
can dis-
charge any
pauper
‘Tunatic
confined in a
licensed
house.
100 MANUAL OF LUNACY
ing a pauper relative confined in an asylum can obtain
it upon reference to the Commissioners in Lunacy, 19
Whitehall Place, S.W.
In Tacensed Hewes.
If in consequence of deficiency of room, or from any
other special circumstances the patient is unable to be
sent to a county or borough asylum, an order and
medical certificate must be obtained, and upon these he
can be received into a licensed house, such “special
circumstances ”’ being stated in the order.
‘The order, statement, and certificate are similar to
those made use of in the case of private patients admitted
into, asylums.
The order can be signed by the same person who is
authorised to sign the order for admission into a county
asylum.
'“Tt shall not be compulsory on the superintendent
of any registered hospital or the proprietor of any licensed.
house to receive any lunatic under any such ‘order’
except in pursuance of any subsisting contract.” *
The guardians of the parish or union are empowered
to discharge or remove a pauper patient confined in a
licensed house, and may order such. If the medical
superintendent or proprietor receive a written direction
from the guardians, he shall discharge the patient, unless
the patient is dangerous or unfit, to be at large. The
Commissioners or visitors can give their consent in
writing in these cases to removal.
The officiating minister and one of the overseers or
any two of the justices will authorise the discharge in
the case of parishes which possess no board of guardians
and visitors. The Commissioners in Lunacy of course
have power to discharge any patient.
The superintendent or proprietor of a licensed asylum
~* 16 and 17 Vict. ¢. 97, s. 78.
PAUPER LUNATICS 101
containing pauper patients must, in the event of the
recovery of a patient, send such notice to the guar-
dians, overseers, or clerk of the peace, as the case may
be, and the patient must be discharged or removed
within fourteen days.
If the patient is not discharged within that time
notice must be sent to the Commissioners in Lunacy
and to the visitors. ‘Of course all notices of removal or
discharge must be sent to the Commissioners and
visitors.
In Workhouses.
On January 1, 1872, there were thirteen thousand
six hundred and eight pauper lunatics in workhouses,
showing an increase of one thousand four hundred and
forty-seven over the preceding year.
The number of workhouses visited during the year
1871 by the Commissioners in Lunacy was two hundred
and nineteen.
No dangerous lunatic, insane person, or idiot can be
detained in a workhouse beyond fourteen days. ‘“ And
be it further enacted that nothing in this Act contained
shall authorise the detention in any workhouse of any
dangerous lunatic, insane person, or idiot for any longer
period than fourteen days, and every person wilfully
detaining in any workhouse any such lunatic, insane
person, or idiot for more than fourteen days shall be
deemed guilty of a misdemeanour : provided always that
nothing herein contained shall extend to any place duly
licensed for the reception of lunatics and other insane
persons, or to any workhouse, being also a county
lunatic asylum.” *
This applies not only to dangerous lunatics, but also
to other insane persons, except under special circum-
stances.
* 4 and 5 William IV., c. 76, s. 48.
Notice of
recovery is-
given to
guardians,
overseers,.
or clerk of
the peace. .
Lunatics
confined in
workhouses..
Dangerous
lunatics
cannot be
detained in
@ workhouse
beyond
fourteen
days,
Lunatic
pauper to
be sent to
asylums.
(25 & 26
Viet. c. 111,
s, 20.)
Lanatics
wandering
at large.
102 MANUAL OF LUNACY
“No person shall be detained in any workhouse,
being a lunatic or alleged lunatic, beyond the period of
fourteen days, unless in the opinion, given in writing,
of the medical officer of the union or parish to which
the workhouse belongs, such person is a proper person
to be kept in a workhouse, nor unless the accommoda-
tion in the workhouse is sufficient for his reception ;
and any person detained in a workhouse in contraven-
tion of this section shall be deemed to be a proper
person to be sent to an asylum, within the meaning of
section 67 of the Lunacy Act, chapter 97; and in the
event of any person being detained in a workhouse in
contravention of this section, the medical officer shall,
for all the purposes of the Lunacy Act, chapter 97, be
deemed to have knowledge that a pauper resident
within his district is a lunatic and a proper person to
ye sent to an asylum, and it shall be his duty to act
accordingly, and further to sign such certificate as is
contained in Schedule F to the said Act, No. 3, with
a view to more certainly securing the reception into an
asylum of such pauper lunatic as aforesaid.” .
The Commissioners can themselves order any pa-
tient confined in a workhouse to be removed to a
licensed house or asylum, as they may think proper.
LInnatics wandering at large,
I refer to private as well as pauper patients. It often
happens that insane people are found wandering at large
in the streets or public thoroughfares. A lunatic found
thus wandering is taken before a justice of the peace.
This is done by a constable, relieving officer, or
overseer of the district, and if any of these officials are
informed of the fact that a lunatic is at large they are
legally bound to take the patient before a magistrate.
Any person may give information relating to lunatics
wandering at large either to the relieving officer, over-
seer, constable, or to the justice himself.
PAUPER LUNATICS 103
The lunatic having been brought before a justice, a
medical man is called in, and upon his signing one
medical certificate, according to the Act, an order will be
given by the justice for the reception of the lunatic into
an asylum or licensed house. The justice can also act
upon his own knowledge and examine the lunatic at his
own abode, or wherever he thinks proper to conduct his
examination.
“Hivery constable of any parish or place, and every
relieving officer and overseer of any parish, who shall
have ‘knowledge that any person wandering at large
within such parish or place (whether or not such person
be a pauper) is deemed to be a lunatic, shall imme-
diately apprehend and take, or cause such person to be
apprehended and taken before a justice ; and it shall also
be lawful for any justice, upon its being made to appear
to him ‘by the information upon oath of any person
whomsoever that any person wandering at large within
the limits of his jurisdiction is deemed to be a lunatic,
by an order under the hand and seal of such justice, to
require any constable of the parish or place, or relieving
officer or overseer of the parish where such person may
be found, to apprehend him and bring him before such
justice, or some other justice having jurisdiction where
such person may be found ; and every constable of any
parish or place, and every relieving officer and overseer
of any parish who shall have knowledge that any person
in such parish or place, not a pauper and not wandering
at large as aforesaid, is deemed to be a lunatic, and is
not under proper care and control, or is cruelly treated
or neglected by any relative or other person having the
care or charge of him, shall, within three days after
obtaining such knowledge, give information thereof
‘upon oath to a justice, and in case it be made to
appear to any justice, upon such information or upor
the information upon oath of any person whomsoever,
Provision as
to lunatics
wandering
at large,
not being
properly
taken care
of, or being
cruelly
treated, &c.
(16 & 17
Vict. c. 97,
a. 68.)
104 MANUAL OF LUNACY
that any person within the limits of his jurisdiction
not a pauper, and not wandering at large, is deemed
‘to be a lunatic, and is not under proper care and
control, or is cruelly treated or neglected by any
relative or other person having the care or charge
of him, such justice shall, either himself visit and exa-
mine such person and make inquiry into the matters so
appearing upon such information, or by an order under
his hand and seal-direct and authorise some physician,
surgeon, or apothecary to visit and examine such person,
and make such inquiry, and to report in writing to such
justice his opinion thereupon ; and in case upon such
personal visit, examination, and inquiry by such justice,
or upon the report of such physician, surgeon, or apo-
thecary it appear to such justice that such person is a
lunatic, and is not under proper care and control, or is
cruelly treated or neglected by any relative ‘or other
person having the care or charge of him, it shall be
lawful for such justice, by an order under his hand and
seal, to require any constable of the parish or place, or
any relieving officer or overseer of the parish, where such:
person is alleged to be, to bring him before any two
justices of the same county or borough; and the justice
or justices (as the case may be) before whom any such
person as aforesaid in the respective cases aforesaid is
brought, under this enactment, shall call to his or their
assistance a physician, surgeon, or apothecary, and shall
examine such person, and make such inquiry relative to
such person as he or they shall deem necessary ; and if
upon examination of such person or other proof such
justice be satisfied that such person so brought before
him is a lunatic, and was wandering at large, and is a
proper person to be taken charge of and detained under
care and treatment, or such two justices be satisfied
that such person so brought before them is a lunatic,
and is not under proper care and control, or is cruelly
PAUPER LUNATICS : 105
treated or neglected by any. person having the care or
charge of him, and that he is a proper person to be
taken charge of and detained under care and treatment,
and if such physician, surgeon, or apothecary sign a cer-
tificate with respect to every such person so brought
either before one justice or two justices, according to
the form in schedule (F) No. 8 to this Act, it shall be
lawful for the said justice or justices, by an order under
his or their hand and seal or hands and seals, according
to the form in schedule (F) No. 1 to this Act, to direct
such person to be received into such asylum as herein-
after mentioned, or, whereimafter authorised in this behalf,
into some hospital registered or house licensed for the
reception of lunatics, and the said constable, relieving
officer, or overseer who may have brought such person
before the said justice or justices, or any constable whom
such justice or justices may require so to do, shall forth-
with convey such person to such asylum, hospital, or
house accordingly: provided always that it shall’ be
lawfal for any justice, upon such information on oath as
aforesaid, or upon his own knowledge, and alone, in the
case of any such person as aforesaid wandering at large
and deemed to be a lunatic, or with some other justice,
in any other of the cases aforesaid, to examine the person
deemed to be a lunatic, at his own abode or elsewhere,
and to proceed in all respects as if such person were
brought before him or them as hereinbefore mentioned ;
provided also, that it shall be lawful for the said justice
or justices to suspend the execution of any such order
for removing any such person as aforesaid to any asylum,
hospital, or house for such period not exceeding fourteen
days as he or they may deem meet, and in the mean-
time to give such directions or make such arrangements
for the proper care and control of such person as he or
they shall consider necessary : provided also, that if the
physician, surgeon, or apothecary by whom such person
‘106 MANUAL OF LUNACY
is examined certify in writing that he is not in a fit
state to be removed, the removal of such person shall be
suspended until the same or some other physician, sur-
geon, or apothecary certify in writing that such person
is fit to be removed ; and every such physician, surgeon,
and apothecary is hereby required to give such last-
mentioned certificate as soon as in his judgment itought
to be given: provided also, that nothing herein con-
tained shill be construed to extend to restrain or pre-
vent any relation or friend from retaining or taking such
lunatic under his own care, if such relation or friend
shall satisfy the justice or justices before whom such
lunatic shall be brought, or the visitors of the asylum
in which such lunatic is or is intended to be placed, that
such lunatic will be properly taken care of.”’
The following table contains a list of all the county
and borough asylums in England and Wales, the name
of the towns in which the asylums are situated, the
medical officers or superintendents connected with them,
and the number of patients remaining on January I,
1872. Following this is a table from the Commissioners’
Report of 1872, in which is given the various charges.
made for patients at the different county and borough
asylums.
107
PAUPER LUNATICS
“3m apts’
020% | o10's | ere'T | 228 —- }j-|- Ueber Sica een "+ + yoqeR Meupog f+ * + xasOIPPITT
68¢ 68¢ sog $83 a — | fl of aeuied “a “Ad | Wjooupaweu‘espriqeoeig {* * = * + ajooury
967 ese S6L O61 iid se | oT |* (aoading) youg *¢ * qeqsooleT | * puByny pus toyse016T
800°T | S00'L | 229 9Lb ai ag eee (wossiing) 4oT YH | Jeysoyouspy‘au‘yormysaig |* * 5 at
919 919 ogg Tee a —]— [tf sw80g'T Ed |* yooserg zou ‘TTqurey |} > os ltt “
2c0'T | 220°L | . 6h ee¢ = — | — | (@oaSing) qsangpeorg rp] * * dooyaeysvouey.|* °° Joysuouey
* eu Te \
eet | sect | oz | 229 — |} = |e wun a a ac io wou “qqvoEs sae * 8 + ‘quoy |.
FOL FOL == FOL a = —|* ueumdeyo "VL ‘id | ° : * pioyer1ayH | * © s * plojoraH
829 Te9 cee 982 L 9 T ‘ ] * Aoluey "fig | * weyereg qeou ‘epwouy }* + + symeR
88¢ seg 11g PLB & z T * s(uoe8img) wNOLE | * 2 * seyseonoy|* : + raqsoono19
LEP LOP 206 FS — = = * SaeTMOT[9A "CG “Ad | * s ° * puespiug | ° * . UBss1OULE[y)
869 869 06e 208 ee — | — [2 TWeadmeppreaogssaq |} * * * . poomquaig | + * + + xassgt
209 009 Us 62 L ¢ z : * yqtug “yA Tre 4119 qvou‘ppyespeg |* * * * wey
10¢ 81 092 81% & 6 7I =| * (woadimg) saurdg “pH *¢ " deqsoqotog wen |" * * + gastog
FOL FOL 987 89% = — )— ft Sepuneg‘ssr pad | * + aegsugueg |* + + * oso
88s 188 90% I8t I = if ‘8 weuQoytA "ef “Id | * Aqieqd qeau ‘MeaospporE | * +t * Aqua
* * qyouoreyy
16g Log. 681 SLL F% IL gL * (moading) seuor TQ | * . * * ysiqueq {poe quyg ‘woarea
-1ey “eesopsury ‘ysiqueq
HOP 288 PLL €1Z ral L or |* * wong ‘gna | * +" epstiteg zeayy tee AA pus 2
89> clr 88 eT SF 4) 1% |! *suepy preyorg tq |= * + urumpog | * + Teaut0p
$6 868. I9T aa j zg = {Ll tsa WW 'd “1d | Pleysooowyy “a ‘episyzeg |* pore
POP ¥0F P6L 01’ = — | — [* * Uospraed "Hf Ig ‘ qeysogg |° + 2 * > ‘zaqsaug
° qSOA\ p10y
18% Tes 9ST SSL ha — —j° * geplwey eH ‘id |* s * weyqreurre9 pus ‘ayoiquieg
? ‘uesiprey ‘ueqyeULIeD
193 193. | 981 SBI = —/—{* 3 wwg'm'p'yd|* "= * * tmoqng Aig Jo a[sI pus espraqured
age 28 103 Se or ¥ 9 (aoeBmg) drqduing ugor | * AmmqsojAy zwou ‘ouoyg +" syong
876 896 Bel 9IL = | * PURI “A “A “IC | pIOYSUNTEMIwou‘fesjoyO |- + + SHAG
819 819 82g 062 oS — | — |* -(aoaamg) euued "M * xoopreg ‘fesajty | + symp pus ‘sy ‘spag
TOL | ‘W | TOL | ‘a | ‘NW |
€ ee S181 SI90WO TOPE
a S181 ;
wo _ | Arenuer wo ‘{ Arenuee wo pus eUENIIG ETO A. ae Sea a
poryeuny| Bupurewer syuoneg Sururemar syueyed f syuapuayuptedng eHUNOD payay
1890, - : .
uadaAvV GLVALE =
MANUAL OF LUNACY
108
19962 gestae res‘et| cer‘et| sos zot | set |*
TO TOL 1¢ og = = — |° (moadimg) uoqqng “7 | * ie . * GOrMJON | * Os? 09% 08% 8 % % * * Aosted “HM “IC |" WOME awou “uoqeH | © St HOTAMTE MN
09 009 Tre 6% =|. 3 — /2 * SUPIEM “C'M SIC] + * UseoH spremdeH | st * xeasng
829 829 288 86% = — | — ft Pregasntg “NL 1a | SapyoM teow “poomyoorg |* 5 f°
086 0¢6 Pee 907 oma (| a he & ssatq ‘8 ‘¢ ‘IC * * BUr0CT, TON : fatmg
POP POP Fs Ist = — | — [* ¢ weuri rf ad | esprqpooM aveu ‘aoyey | * ‘5 -¥logng
8s acy 01 SI & I z * ft swe “Vv 'e IC | PleyWrI ‘aa ‘poomguing j* : 8 t
Tog To¢ 98% $98 = —]— ][* 8 mom NW aa |" 5 ff popes] fF DrOpTIS
eg oig G13 G8 8 6 , qooTTpATL “WO 'M 'O “IC _ SPA | ° * 4 3 iS
yg =| F1g 083 | 8% — |—] — [tot e8ueng -y ‘ad | Sinqsmergg qeou ‘uoqotg | * Aremosquop, pus dopes
09% 09% 193 661 = — | — | (8mg) fequeg “HH | * PxOpxO qwou “oromepT |° * 5S BLOHXO
eLg €18 00 eLT ra —|—- [2 4 gms ‘dM IC J emaaMON | T 8}40N
#g8 e9e 89 gs T — {1 * — (WoaBIng) UOSITA “HL medion Ta “pooarsu1940) * PuEpLeqummysz0NL
OW OW 19% 6L1 rae —}—-— |* ° ° STH ‘OA Ad YOHMION sven ‘adiogy | ° song pea
ser cer £83 608 i — | — |* anompom Mad iad|*' ° = * Auueaesieqy lipgostons ‘qqnoumm0yy
‘AespurT Wd |}. 6 lee 4
26u‘t | L6L'T | 960°L | TOL = i || Ses { ‘ Gane AK at Teauey xaso[PPryL
TeqO.L, ‘a ‘N | 10L | ‘a | ‘W
Tue ZL8L s120O Teorpeyt
T‘uee CLEL t Snoz0
uo ‘{ Avenuep wo ‘{ Avenuep uo pue ayenyig ee pus eeraien oy
Oyen] + Bulupener sues SUIUIeUIL sz UOTVVq syuspuequrtiadng . 7
TeIOL
wWadAVE GLVAIg
*panuyjuoo—SNOTASY HOnONOg aXvV ALNNOD
PAUPER LUNATICS
109
4 b 2 u
Ba ¢ ieee, | #99 | Sy
So 3 AE & BS 4
ae a EB es" a| @o8 eg
2 3 om | BO83| Pas 3
a0 _S
8A a es ‘ és a Aas Aa
ia 8 Bae | bos g 2 s
ee é aS (| Se8e| zee | we
ag g° | S284 | 323 | ga
oF a |" a8 E'S
s. d. x. da. sd. 3. ad.
Beds, Herts, and} |, tesey, Baldock .| 8 11 |(a)8 10} | 14 0 =
Cholsey, near
Berks . «| {HPS soca {lO 74 18 0 ee aes
: 1(9 4 :
| Stone. near 4 to
Ce ee sae al and } 14 0 i ‘
Cambridge and AN
- [si ot iy ‘| |Fulboun . flo 8] 9 11 | 4 0 oe
jOsmmarthan, Gar: } 9 4)\(13 11
digan, Pem-
broke. and Ha- j Carmarthen | 9 6 | ou } {ad -
verfordwest .
Chester . . Chester. . | 9 O28 7 7 14 0 —
Parkside, near {" 9 3 9
< . . 41 3 911 and to
7 { Wandeanea 2 0 20 0
} 3 10 0
Cornwall - Bodmin . - fl0 4 9 6% 10 6 to
er5 : 84 0
|Cumberland and ca
[Ormbarland ond} |Near Carlisle’. | 9 al{ and } oo | 4 o
‘Denbigh, Angle- 12 10 12 6
sea,Carnarvon, ‘
Flint, and ze (Denbigh % -| 8 103) 8 2 i , {25
rioneth . . ie %
mo 1
| Mickleover, )
Deby » + ff Macar Derby ’.f| 9208) 9 9 {ey 14 0
Devon . . «.Hxminster . .| 8 38] 9 12 6
11 6 10 0
‘Dorset . » «|Near Dorchester .| 6 113; 7 0 to t
a 12 0 14 0
Sedgefield, near ‘ ,
Durham. . | { Seggetelipnrar|| 9 53) 9 9 | 14 0 | 16 @
Essex. . .|Brentwood . -.| 9103} 10 0 -| 14 0 _—
Glamorgan . _ .|Bridgend - «811g 9 0 a joey
Gloucester . Gloucester . | 8103} 8 6 {304 [and
11 0
Knowle, near
Bente . . .|{ Snowle mest} | 8 11g) 9 Ob {5 4 0
Hereford . »|Hereford lB 8} 16 6 es a
ppeeeae
Kent . . | Teer Maid- {10 0| 911 14 0 _
stone . =
Lancaster -}uancaster Boor | |7 9h 77) 40 _
Rainhill, near
” . Hf Prescot “ 9 4 : : 140 7
Prestwich, nr.
ss ‘ A ee h 9 oy | gua } 4 0 pas
Leicester and A
eee. 1) |Leicester 9 6 90 | 14 0 911
a Average.
110 MANUAL OF LUNACY
eo | 3 |e
ec 8
Z2 ¢_|sese| *28 | 4
Sy z Ee lessee | Be8 | Be
3 g k
#8 a ge | ecCSa| fea | ay
aa e gk /6pag| Of | Sa
ga g 48/298] »e8 | 28
24 P ge | S885] Fre | FE
3. & |Fsy | ENS | &
< & a.| & da & a & dd.
2 Bracebridge = =
Lincoln . es { eae Tieesin f 8 81) 8 8}
Middlesex , .|Colney Hatch | 9 8 a a 14 0 _
» + Hanwell + 10 al { and } 14 0 Ns
9 7%
‘Monmouth, Here- 12 0
ford, Brecon, } |Abergavenny. | 9 O# 9 0 and _—
and Radnor . ne : 14 0
orpe, near ase
Norfolk . Norwich} [8 7] 9 9 | 14 0
Northumberlana | {Cottngwood. } iia og} 9 4 | 14 0 | 15(min,)) °
near Morpeth
Notts . ‘ + aeneee » A991 8 6 14 0 =
ittlemore ( c
Oxford. wl, {sear ator »} 9 9 9 33 | 1 7
Salop and Mont- Bicton,” near a
gomery . “I { Shrewsbury } 9 2% 68 8 7 te ny
Soi t |Wells . . |9 1 8 9 to: to
ree “oe _ 140 J| lat 0
Stafford . “patord a | 8 103} 8 9 14 0 —
urntwoo
” . { ena: 8 8 Bi 1410 14 0
Melton, near
suo. . {MEMO ace tf} 9 oe] 9 6 | ae |
Surrey .. i rooHae . 10 8} 10 0 14 0 =
rookwood,’ Bes
med a. San HE oar Wobing 10 33] 10 6 14 0
Sussex . : .|Hayward’s Heath .| 9 8 ait 14 0 af .
: Hatton, near
Warwick 7 a 3 9 2 { and 14 0: | to
{ Warwick . 9 Tk ae 0
Wilts. . .|Near Devizes 18 3 77 ae —
: : 8 2
Powick, near 7
Worcester . { ‘Worcester “} 8 5t 8 2 14 ©: { i,
' 13 5 )| (14 0
York, N. Riding .|Clifton, near Yorkj10 23] 8 9 ee } {ve
» W.Riding [Wakefield , «| 9 63/(a)9 74 | 14 0 ee
Birmingham . . . ’ . | 7 8) 8 0 40 {we
Bristol (Stapleton, near*Bristol) . (12 03) 12 0 14 0 20 0
Hull . . . . . . 14 4% 10 6 F 0- _
5 2
Ipswich , % ‘ A ‘ . (11 6] 183 0 a } 20 0
6 0,
London (City of), Stone, near Dartford|12 0] 14 0 14 0 -
3 < 10 6
‘Leicester (Humberstone) ,. , ,|10 7] 10 6 {) to: _—
4 0
7 e . 12 0 16 0 14 0
INewcastle-on-Tyne (Coxlodge) . .|10 63 { and } { and to
11 0 14 0 29 0
(Norwich (the return from Norwich In-
firmary has not been received) a |= _ — as
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 111
CHAPTER VIII.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS.
THE ancient mode in dealing with the property of per-
sons of unsound mind, was for the King, upon a petition ancient
being presented to the Lord Chancellor, accompanied by PEeaTes in
affidavits of facts relating to the insanity, to issue a writ O°"
to the Sheriff or Escheator of the county, so that the
case might be tried by jury, and so ascertain by personal
examination whether the person was of unsound mind.
The Escheator was an ancient officer, so called be-
cause the nature of his office was to look to escheaits,
wardships, and other casualties belonging to the Crown.
The writs, which were returnable into the Court of
Chancery, were of various forms, one writ being whether _
the lunatic has had no understanding from his nativity,
and consequently an idiot, and so presumed by law never
to attain any mental capacity,
The Sheriff or Escheator before whom the alleged
lunatic was examined, having come to a decision that
the person was of unsound mind, the lunatic was en-
titled personally, or through his friends, to come into
the Court of Chancery or before the Chancellor, or the ;
“coram rege im concilio” (King’s council), and, having
.placed the matter before them, he might petition to be
examined by them as to whether he was compos or non
compos mentis; or might issue a writ out of Chancery
to certain individuals, to bring him who had been so
found lunatic before the King in his council at West-
112 MANUAL OF LUNACY
minster, and there be examined. If upon examination
he was found to be compos mentis, notwithstanding the
Sheriff or Escheator had given his verdict of non com-
pos mentis, the verdict would, of course, be upset or
traversed in consequence of that given by the Coun.
cillors at Westminster.
Persons of unsound mind were divided into two
classes, idiots and lunatics, and a distinct commission
was required for each of these individual classes. Inthe
first the commission was de idiotd inquirendo, and in the
other de lunatico inquirendo. Three of the regular
Commissioners appointed by the Lord Chancellor were
authorised to execute a commission in the nature of a
writ de ,lunatico inquirendo; this was returned to the
Lord Chancellor duly signed and sealed, after the jury
had held their inquisition.
By virtue of the royal prerogative, all persons pro-
nounced of unsound mind and incompetent to take care
of themselves or manage their property, are placed under
the protection of the Crown.
Four classes Lord Coke mentions four classes of persons non com-
of persons | . =
non.compos pos mentis, to whom the royal prerogative extends.
mentis, rs
according to ' 1st. Idiot, or fool natural.
Coke,
aa 2nd. He who was of good and sound memory, but,
by the visitation of God, has been deprived of it. ~
8rd. Lunaticus qui gaudet lucidis intervallis and
sometimes is of good and sound memory, and sometimes
non compos mentis.
4th. He that is so by his own act, as a drunkard.
The distinc- In former times the distinction between an idiot and
tion between oe Gia *
an idiot and a lunatic was important. i
oo The care of the person and estate of the born idiot
omen was entrusted to the lord of the fee, whereas that of the
importance. lunatic was under the prerogative of the King; but in
the present day, whether the person is an idiot or a
lunatic, his person and estate are under the protection
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS "113
of the Crown, but though it has the protection of the
person and estate in both instances, the interest pos-
sessed by the Crown is different. In that of a lunatic
the Crown has simply the duty of acting as a trustee,
and taking care of the person and property for the sole
benefit of the particular individual. In the case of an
idiot the Crown has both a trust and an interest; and
after making provision sufficient for the requisite wants
of the idiot and his family, it can take the profit of the
estate for its own use.
The Crown, in the event of the recovery of its charge, ©
restores the estate to him, or, in the event of his death,
to such members of the family as are legally entitled to
it, in as nearly the same condition as when it first took
the management of it.
There are two ways of dealing with the property of
a lunatic : 7
Ist. When the property exceeds 1,000/. or the in-
come is more than 50/. per annum.
2nd. When the: property does not exceed 1,000J. or
the income 50/. per annum.
Let us consider the first of these.
Mode of Procedure, and Object of Enquiry.
The object of a Commission in Lunacy is to enable
the Crown, or the Lord Chancellor, as its representative,
to protect, and deal with as he may think proper, the
property of persons of unsound mind.
The Lord Chancellor will appoint committees of the
lunatic’s person and estate, who are the representatives
of the lunatic in all matters. :
Mode of Procedure prior to Commission.
It is customary for one or more members of the
family of the alleged lunatic to present a petition to thé
Lord Chancellor.
I
Upon the
death or
recovery of
the lunatic,
the estate is
no longer
under the
jurisdiction
of the
Chancellor.
Two modes
of dealing
with pro-
perty of
lunatics.
Why a com-
mission in
lunacy is
held,
Prelimin-
aries prior
to com-
mission.
114 MANUAL OF LUNACY
This is signed by the petitioners, and attested by a
solicitor duly admitted into the Court of Chancery.
I give below a form of petition.
PETITION OF ENQUIRY.
In the matter of L. B., a supposed Lunatic.
To tae Ricur Honovrasre THe Lorp CHANCELLOR OF GREAT
i Brirain.
Petition for
enquiry. The humble petition of W. H. of and H.I. of
showeth that L. B., now residing at
is now, and for the space of last past, hath been
of unsound mind, and altogether unfit and unable to govern herself
or to manage her affairs, as by the (accompanying affidavits or the)
affidavits hereto annexed appears.
That your petitioner, W. H., is the paternal nephew of M. B.,
the late husband of the said L. B.
Your petitioners therefore humbly pray your Lordship, that the
Masters in Lunacy, or one of them, may be directed to enquire and
certify concerning the lunacy of the said L. B.
And your petitioners shall ever pray, &c.
W. 4H.
; H.1.
Witness to the signing by the said W. H. and H, I.
R. H., Solicitor of (Address.) :
These petitions must be accompanied by affidavits of
Medical and medical men, and of members of the lunatic’s family,
other affi- .
davits must and others to whom he is known.
petition, They must contain facts relating to the alleged un-
soundness of mind, and the reasons for coming to this
conclusion, and state the symptoms of mental aberra-
tion.
All affidavits made in lunacy must’ be made and ex-
pressed in the first person of the deponent, divided
and numbered in paragraphs consecutively, and respec-
tively confined as nearly as possible to distinct portions
of the subject-matter.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 115
AFFIDAVIT OF MEDICAL MAN IN SUPPORT OF
COMMISSION, :
I, William Pemberton, of 42, Glasgow Square, London, Doctor
of Medicine of the University of Edinburgh, and Fellow of the
Royal College of Physicians of Edinburgh, have this day personally
examined John Smith, a person residing at 12, Egan Road, London.
I consider him to be a person of unsound mind, and quite in-
capable of managing himself or his affairs.
T have arrived at this conclusion from the consideration of the
following facts :—
1. He is under the delusion that his food is poisoned by his
relatives, and consequently he refuses to eat.
2. He is quite ignorant of the amount or the value of his pro-
perty.
8. He cannot tell me where he is, and the day of the week,
month, or year.
4. His conversation is incoherent and irrational,
(Signed)
W. Pemperton, M.D., F.R.C.P.E.
42, Glasgow Square, London.
: June 4, 1872,
This affidavit is sworn before a Commissioner autho-
rised to administer oaths in Chancery ; and, having been
returned to the solicitor who is conducting the case,
is forwarded, with the petition, to the Lord Chan-
cellor.
The nature and amount of the alleged lunatic’s pro-
perty must be stated in the affidavits made by the
members of the family, and the names of his nearest
relatives are required to be given.
These affidavits must not be sworn before the solicitor
of the petitioner, but before some other solicitor authorised
to administer oaths in Chancery.
The petition, with the affidavits, is now filed with the
Registrar in Lunacy, who prepares office copies of them
‘for the persons concerned in the enquiry,
The Registrar marks upon the original petition the
12
Form of
medical
affidavit.
Swearing of
affidavit.
Particulars
relating to
the notice of
enquiry
being sent
to the
lunatic.
Enquiry
conducted
by jury.
116 MANUAL OF LUNACY
date of its presentation, and then returns it to’ the
solicitor, who will serve it upon the alleged lunatic.
‘It is requisite, in the case of a lunatic who is married,
and whose husband or wife does not petition the Court,
that evidence should be given in writing, and proved
by affidavits, that the husband or wife, as the case may
be, consents or is acquainted with the proposed enquiry.
The affidavit of assent must be lodged with the Registrar.
The alleged lunatic must have notice sent him of
the intended enquiry.*
“Where the alleged lunatic is within the jurisdiction
he shall have notice of the presentation of the petition
for enquiry, and may, by a notice, signed by him, and
attested by his solicitor, and filed with the Registrar,
either before the presentation of the petition, or within
seven days after such notice had by him as aforesaid, or
at or within such other time as the Lord Chancellor,
entrusted as aforesaid, shall order in the particular
case, demand an enquiry before a jury.” +
We do not often find a patient demanding to be tried
‘before a jury, as the majority of cases are incurable.
lunatics, who, upon the presentation of the citation to
them, will either not look at it or tear it up immediately.
Let us suppose the alleged lunatic, upon receiving
the citation, demands a jury.
“Where the alleged lunaticdemands an enquiry before
a jury, the Lord Chancellor, entrusted as aforesaid, shall,
in his order for enquiry, direct the return of a jury, unless
the be satisfied, by personal examination of the alleged
‘lunatic, that he is not mentally competent to form.and
express a wish for an enquiry before a jury; and the
Lord Chancellor entrusted as aforesaid may, where he
shall deem it necessary, after presentation of the petition
* The solicitor, or one of his clerks, will call upon the lunatic
.and show him the original petition, and present him with a copy of it.
wf 16 and 17 Vict. c. 70, s. 40.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 117
for enquiry, and for the purpose of personal examination,
require the alleged lunatic to attend him at such conve-
nient time and place as he may appoint.” *
If the lunatic does not demand a jury, or the Lord
Chancellor, as before mentioned, is satisfied that the
patient is not mentally competent to form and express
a desire in that behalf; and if there is no opposition to
the enquiry being held, and the Chancellor is satisfied
with the evidence and propriety of the enquiry, and also.
satisfied that due notice has been given to the alleged
lunatic, and that the time in which a jury could have
been demanded has expired, the affidavit of service
having been duly filed with the Registrar, an order for
the enquiry is given.
Order for the enquiry having been given, the special
order is prepared by the Registrar in Lunacy, who de-
livers it to the solicitor who has the charge of it. It is
signed by the Lord Chancellor or Lords Justices, and is
on a paper impressed with a 21. Chancery stamp.
I here give a form of the order without a jury :—
That F. B. and S. W., Esquires, the Masters in Lunacy, or one
of them, do, in pursuance of the General Commission under the Great
Seal of Great Britain to them for that purpose directed, enquire
by the oath of good and lawful men concerning the alleged lunacy of
the said H. K., now residing at, &c.; that the said enquiry be held
at the place of abode of the said H. K., or as near thereto as con-
veniently may be.
Where a jury is directed, the order is as follows :—
That F. B. and 8, W., Esquires, the Masters in Lunacy, or
one of them, do, in pursuance of the General Commission under the
Great Seal of Great Britain to them for that purpose directed, en-
quire by the oath of good and lawful men concerning the alleged
lunacy of the said J. N., now an inmate of, &c., at, &c., and that the
said enquiry be held at the place of abode of the said J. N., or as
near thereto as conveniently may be, and that a good jury of the
said county and of the neighbourhood where the said J. N. resides
be returned to enquire of his lunacy.
* 16 and 17 Vict. c. 70, s. 41.
No jury
demanded.
Order for
enquiry.
Power of
the Court
to grant or
refuse order.
Caveat.
Form of
caveat.
118 MANUAL OF LUNACY
The Court has power to refuse or grant the order
for enquiry at its discretion. It sometimes happens
that more than one petition is presented to the Chan-
cellor; but it is usual to give preference to the peti-
tioner whose petition was first presented.
The petitioner may be called upon to defray all ex-
penses connected with the enquiry ; and if he die before
the execution of the order, a new order or petition must
be obtained, stating by whom the enquiry-is to be
presented.
The lunatic in the meantime remains within the
jurisdiction of the Court pending the commission.
The commission will now have to be held, and any
person preventing such enquiry is liable to a contempt
of court.
Opposition of Commission.—Caveat.
If the petition is opposed, or a caveat lodged,
or the application is made by a stranger or relative,
without the assent of the husband or wife, the petition
will be set down for hearing before the Lord Chan-
cellor or Lords Justices.
IN LUNACY.
In the matter of L. B. of
Caveat against the petition of enquiry in lunacy herein, without
notice to C. of, &e., Solicitor on behalf of
Dated this day of 1878.
(Signed)
If the petition is presented by a stranger, it must
be served, when answered, upon the nearest relative
of the alleged lunatic; or if it is presented without the |
consent of husband or wife, it must be served on the
husband or wife, as the case may be. After the serving
of the petition, and after the service or consent has been
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 119
proved by affidavit, the matter is heard in court, and an
order pronounced thereon.
Power of Commissioners in Lunacy to enquire into
Lunatics’ Property.
When the Commissioners have reason to believe
that the property of the alleged lunatic is not duly pro-
tected, they are empowered to report to the Lord Chan-
cellor.*
“Where the Commissioners in Lunacy for the time
being shall, after the commencement of this Act, by
virtue of any authority for the time being enabling
them in that behalf, report ‘to the Lord Chancellor, en-
trusted as aforesaid, that they are of opinion that the
property of any person alleged to be a lunatic, or de-
tained or taken charge of as a lunatic, but not so found
by inquisition, is not duly protected, or that the income
thereof is not duly applied for his benefit, or to the same
effect, the report shall be filed with the Registrar, and
shall be deemed and taken to be tantamount to an ordi-
nary petition for enquiry, supported by evidence; and
the alleged lunatic shall have notice of the report from
such person as the Lord Chancellor, entrusted as afore-
said, shall from time to time direct; and the case shall
proceed and be conducted, as nearly as may be, in all
respects as is hereinbefore directed, upon the presentation
of a petition for enquiry.”
A lunatic residing in England, and who possesses
property in Jamaica, where he was found lunatic, in
ordér to obtain protection from the Lord .Chancellor,
must nevertheless be the subject of an enquiry in Eng.
land.
Previous to the commission being held, funds are
directed by the Court to be placed at the lunatic’s dis-
posal to defray the expenses of the enquiry ; and.during
* 16 and 17 Vict. c. 70, s. 54,
Property of
Innatics
not properly
protected.
Expenses
connected
with er-
quiry,
Procedure
of enquiry.
Place for
enquiry.
Evidence
proving the
insanity
must be in
readiness.
Witnesses
are sum-
moned.
Subpeenas
issued.
120 MANUAL OF LUNACY
the time it is pending, necessary arrangements are made
‘by the Court for protection of the alleged lunatic’s
estate.
The enquiry into the state of mind of the alleged
lunatic is conducted by one of the Masters in Lunacy,
unless the Lord Chancellor shall order it to be held
before a jury, or the alleged lunatic demand one, or the
Master considers a jury necessary, or the alleged lunatic
is not placed within their jurisdiction, or resides abroad.
The order for the enquiry, when issued, must be
taken, with the office copies of the affidavits, to the
office of the Masters in Lunacy, 45, Lincoln’s-Inn-
Fields.
The solicitor conducting the enquiry must, at his
interview with the Master, inform him of a fit and con-
venient place to hold it.
It is customary for the enquiry to be held at the resi-
dence of the alleged lunatic, or at some adjoining court
or inn, or where a room can be found sufiiciently large
to accommodate the witnesses, or a jury, if one is re-
quired. The Master will then appoint a day and place
for holding the enquiry.
Previous to the enquiry being held, the solicitor is
required to have prepared evidence of the alleged luna-
tic’s insanity, and to be able to state who are the heirs
and next of kin, the amount of the property, and, who
are the proper persons to be appointed committees of the
person and estate, and the sum proposed for the alleged
lunatic’s maintenance.
If a verdict of unsoundness of mind is given, the
Master will, by vivd voce evidence, enquire into these
particulars.
The attendance of witnesses on the enquiry is obtained
by a summons, given under the hand and seal of the
Master. :
The solicitor conducting the case can obtain from
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 121
the Master’s office copies of the subpoenas; and having
inserted the names of the several witnesses he proposes
to call, the Master will attach his signature to each sub-
pena. If any doubt arise as to the production of the
alleged lunatic at the time of the enquiry, the Master.
issues a summons for his appearance, and this is served
upon the person in whose charge the lunatic is.
SUMMONS TO PRODUCE ALLEGED LUNATIC.
L. 8. By virtue of Her Majesty's General Commission, under
the Great Seal of Great Britain, bearing date, &c., directed to, &c.,
the Commissioners therein named, and an order of, &c., made, &c.,
to enquire whether , of , in the county of >
be a lunatic or not:
These are to will and require you to produce before the said
Commissioners, or one of them, the said at the execu-
tion of the said enquiry, at the house commonly called, &c., situate
at, &c., on, &c., there to be examined touching the matters afore-
said. And you are to give (Aim) notice accordingly, as also to any
other person or persons who are guardians of (him), or trustees of
(is) estate, that they may appear in (his) defence if they shall think
fit. Given under the hand and seal of me, , one of the said
Commissioners, this day of, &c.
L.8.
To , or such other person or persons as now have the
said in their custody or power.
Any person refusing to produce the alleged lunatic,
when summoned to do so by the Master, can be com-
mitted for contempt of court.
When the enquiry is held, the evidence must be con-
fined to the question whether or not the alleged lunatic
is at the tume of such enquiry of unsound mind and
incapable of managing himself or his affairs; and no
evidence of anything done or said by him any time more
than two years previous to the enquiry can be re-
ceived as proof of insanity, unless the Judge or Master
shall otherwise direct. £
Form of
summons to
produce
Tanatic.
Detention
of lunatic
after sum-
mons has
been issued
is a con-
tempt of
court.
Evidence
must be of
recent date.
Lunatic
may be
present at
enquiry.
Master
empowered
to order the
enquiry be-
fore a jury.
Evidence of
witnesses
residing ~
abroad.
122 MANUAL OF LUNACY
The alleged lunatic has the power and right to be
present at the enquiry; he is personally examined by the
Master, who will call and examine such witnesses as he
may think proper, and ask for such information as he
may think desirable to further the ends of justice.
If the case is a very difficult or complex one, the
Master has power, having duly considered the evidence
adduced, to certify to the Lord Chancellor that an en-
quiry before a jury would be desirable; and he can,
without further notice, issue his precept to the Sheriff,
and the enquiry will be proceeded with in the same
manner as if the Lord Chancellor had ordered a jury
in the first instance.
The room in which the enquiry is held is an open
court for the time being.
When the commission is held upon a person who
is abroad, and consequently out of the jurisdiction of
the Court, it may be necessary to obtain the evidence
of witnesses abroad.
Permission to procure such evidence may be ob-
tained, the Court being first petitioned for the purpose,
and duly supported by proof of its necessity.
The Master will attend on the day fixed for the en-
quiry, and it will be conducted in precisely the same
way as if a jury were present.
If the enquiry is held by jury, the Sheriff empan-
nels persons whose names appear on the special jury
list, and are resident in the immediate neighbourhood of
the alleged lunatic’s house.
The case is conducted before the jury by the Master
explaining to them the object and nature of the enquiry,
together with the principles of the law respecting it
and the several points to which the jury must direct
their attention. 3
‘If a counsel in support of the enquiry is engaged, he
opens his case by informing the jury what he intends
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 123
to prove; and having done this, he calls his wit-
nesses.
When no counsel appears in support of the enquiry
the Master states to the jury, as far as he is able, from
the affidavits on which the enquiry has been granted, the
nature of the case at issue.
The witnesses are examined by the Master, or by
the solicitor for the enquiry; and having personally
examined the alleged lunatic, he sums up the case,
and directs the jury to consider their verdict.
If the enquiry is opposed, the counsel cross-examines
the witnesses; and after their examination the Master
examines the alleged lunatic, and the case is summed
up by the counsel for the enquiry. __
The counsel for the opposition then states his ob-
servations upon the case, and produces evidence en-
deavouring to show the sanity of the person.
The counsel for the enquiry now replies, and the
Master sums up the case, and directs the jury to consider
their verdict.
The jury never come to a decision without personally
examining the alleged lunatic, except when the lunatic
resides abroad; but in these cases the evidence must be
most conclusive. When no jury is assembled, the
Master, having pronounced his verdict of the lunatic’s
inability to manage himself and his affairs, fills up and
signs the necessary document, and attaches the seal to
the parchment.
Appointment of Committee or Guardian of the Patient's
‘Estate and Person.
The person having been pronounced by the Master
_to be of unsound mind and incapable of managing him-
self and his affairs, he will become a Chancery lunatic ;
and the next thing to be considered is the appointment
of committees. This is occasionally settled in court
Case stated
by Master,
Examina-
tion of
alleged
lunatic by
jury.
Committe2.
124 MANUAL OF LUNACY
immediately succeeding the enquiry, or by the Master
in chambers, in consultation with the solicitor.
Proceedings Immediately after the inquisition the Master will
ay enquire and report on the following matters :—
1. The lunatic’s situation.
2. The nature of his lunacy.
3. Who are the persons most fit to be appointed
committees of the person and estate.-
4. Of what the lunatic’s property consists.
5. The amount of income.
6. In what manner and at what expense, and by
whom and where, he has been maintained; what sum
is to be allowed for his past maintenance; whether any-
thing, and what, is due, and to whom, in respect thereof ;
and to whom and out of what fund the same ought to be
paid. ;
7. What is a proper allowance for his future mainte-
nance, and from what time this is to commence, and
from what fund the same ought to be paid.
Facts and A statement of facts and proposals is usually placed
proposals :
tobecon- before the Master, relating to—
one 1. The nature of the enquiry lately held.
2. Who is the heir-at-law and next of kin to the
lunatic.
3. The situation of the lunatic, including age, position
in life, profession, and residence.
4, The nature of the lunacy.
5. The amount and nature of his income, verified
usually by affidavits; and how the money is invested.
6. The maintenance of the lunatic.
Here must be stated the annual amount paid up to
the present time for the maintenance of the lunatic,
who has defrayed the expense; and the sum due for the
maintenance. A scheme must also be drawn up, with
suggestions for the lunatic’s future maintenance.
7. Debts,
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 125
All moneys due to others besides those who have
supported the patient previous to the commission must
be stated, and the names of the creditors given, with the
respective amounts.
8. Committee of person and estate.
State residence and condition in life of the person or
persons who are proposed as committee or committees of
the lunatic’s person and estate, and of their willingness
to act; and that the committee of the estate is prepared
to give the necessary security, and that the committee
of the person is prepared to visit the patient periodically.
The consent of the committees should be produced in
writing.
Affidavits should be produced by some independent
person, stating the respectability and fitness for com-
mitteeship of the proposed committees.
9. Proposal.
Here is given the names of the proposed committee
or committees, together with the proposed sum for
maintenance, and from what time it is to commence.
The Master, having been furnished with evidence in
support of these facts, will at a convenient time proceed
into the questions of the property, maintenance, and
appointment of committees.
Committees.
The heir-at-law, if willing to act, will have the pre-
ference of being appointed committee of the estate; and
the next of kin committee of the person, provided the
Master approve of such appointments. In the selection
of committees it igs customary to give the preference
to relations before strangers.
The committees are required to reside within the
jurisdiction of the Lord Chancellor ; and in the appoint-
ment of such committees special attention is given to
persons who are expected to make the best provision
Persons ©
to act as
committees.
126 MANUAL OF LUNACY
for the lunatic’s welfare and comfort, and to take care
of and protect his property.
The petitioners for the commission have the privilege
of nominating persons as committees, though it does
not necessarily follow that the Master will appoint
them.
The solicitors engaged in the case are objected to as
committees, as also any officer connected with the Court
of Chancery.
The Duties of Committees.
Duty of @ A person who is found lunatic by inquisition usually _
committee, . : .
will have two committees appointed—
1. Commitiee of the person.
2. Committee of the estate.
I. Committee of the Person.
We will first consider briefly what are the duties of
the committee of the person.
The committee of the person superintends the per-
sonal care of the lunatic, such charge being committed
to him by grant when the appointment is determined.
It is his duty to determine the residence of the
lunatic, and to make all other necessary arrangements
for his care and comfort; and to endeavour to carry
out to the letter the scheme originally drawn up for
the lunatic’s maintenance. He must visit the lunatic
periodically, these visits being usually fixed by the Court
or Master; and at these visits he must see that the
lunatic is properly taken care of, and that his bodily as
well as mental state is attended to.
If the allowance for the maintenance of the lunatic
is ‘so much as shall be expended not exceeding a cer-
tain sum,” the committee of the person is required to
place before the Master a yearly account of the expen-
diture,
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 127
If the fixed sum allowed for the maintenance of the
lunatic is not expended, the balance must be placed to
the credit of the lunatic’s estate.
The committee of the person must send to the Visitors
in Lunacy a half-yearly report, in which is stated the
mental and bodily condition of the patient, and any im-
portant change that has occurred in his health since the
last visit. The custody of the lunatic being placed in
his hands, he is at liberty to place him where he likes,
and vary the residence of the lunatic as often as he
may think proper. If the residence of the lunatic has
been fixed by the Lord Chancellor, permission from
the Master must first be obtained before making any
change.
If the committee is desirous to place the lunatic in
an unlicensed house as a single patient, no medical cer-
tificates are required ; an order signed by the committee,
having an office copy of such appointment annexed, is
sufficient authority for the reception of such patient.
The fortnightly medical visitations as required in the
case of ordinary single patients confined in unlicensed
houses are dispensed with.
The committee of the person is required to send to
the Visitors in Lunacy immediate notice of any change
in the Iunatic’s residence, whether the removal is tem-
porary or permanent. And ‘he must also give to the
Board of Visitors his own direction and the name of
the medical attendant of the lunatic.
Tt is left to the discretion of the committee of the
“person to decide what friends may be allowed to visit the
lunatic.
Il. Committee of the Estate.
The duty of the committee of the estate is to receive
the income of the Iunatic’s estate and pay everything
becoming due from it, He must arrange the proper in.
Chancery
lunatics in
private
houses,
128. MANUAL OF LUNACY
vestment of the money and manage everything connected
with the lunatic’s property ; but before taking any ez.
traordinary step in the management he must obtain the
consent of the Lord Chancellor or Master. He must
see that the lunatic’s estate is properly taken care of, and
that the houses, buildings, and structures belonging to
the lunatic are sufficiently repaired, and so kept and
maintained, during the continuance of the grant. All
legal documents, title-deeds, &c., are taken care of by
him, but he is at liberty to deposit these at the Master’s
office. ,
The committee of the estate will have the absolute
power to arrange for the letting, by yearly tenancy, but
not-on lease, of any houses or land that belong to the
lunatic, and he, if authorised by an order of the Lord.
Chancellor, can execute deeds in the name of the lunatic.
. He must collect the rent and money due from the estate,
and pay to the committee of the person the sum for the
lunatic’s maintenance, as well as other money allowed by
the Lord Chancellor for the maintenance of his family.
If any alteration is necessary in the scheme of main-
tenance, the committee of the estate and person must
consult together, and the matter is referred, through
their solicitor, to the Master, to be dealt with by him as
he may think proper.
Accounts must be kept by the committee of the
estate, and he is required to pass his annual accounts at
a certain time appointed by the Master; and any balance
due after the passing of the accounts must be paid into
Court and invested for the interest of the lunatic’s estate.
He must be very particular and precise in dealing
with receipts and payments and other moneys, as he is
liable to be discharged for any irregularity ; and in the
event of the death of the lunatic he may be called upon
by a suit of Chancery to produce an account of his
dealings.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 129
If an action at law is commenced, the lunatic, and not
the committee of the estate, is the plaintiff, as also in an
action brought against the lunatic, he and not the com-
mittee is made the defendant.
In equity the lunatic and committee of the estate are
both made parties.
Under the sanction of the Lord Chancellor, the com-
mittee of the estate, as representative of the lunatic, is
enabled to institute proceedings in the Divorce Court for
a judicial separation on the ground of adultery of the
lunatic’s wife.
If the lunatic is patron of a vacant benefice, the
committee of the estate is not empowered to deal with
the presentation ; it is his duty, through his solicitor, to
communicate with the Secretary of Presentations of the
Lord Chancellor, who is enabled to make the presenta-
tion ; but, of course, in doing so due regard is paid to
the interests of the lunatic’s family.
If the lunatic be an incumbent of a parish, the com-
mittee of the estate should communicate with the bishop
of the diocese, whose duty it will be to nominate a curate
to do the lunatic’s duty, the stipend of the curate being
paid by the committee of the estate out of the lunatic’s
estate. ;
All reasonable expenses incurred by the committee
of the estate are allowed; but irrespective of this there
is no remuneration attached to the office.
On Death or Retirement of Committees.
Before a committee is allowed to retire, permission
must first be obtained from the Lord Chancellor, by
petition or application to the Master, and his report
confirmed by fiat.
Upon the death or retirement of a committee a state-
ment of facts is brought into the Master’s office proposing
a new committee.
K
.
Appoint-
ment of new
committees
in the case
of death.
Death of
lunatic ;
power of the
Master to
deal with
the docu-
ments depo-
sited at his
office.
130 MANUAL OF LUNACY
If the proposal be made for a new committee of the
estate, a statement must be given as to the extent-of the
lunatic’s property.
If a committee of the person is required, the amount
lately allowed and the scheme for maintenance must be
stated; and if it is then found that a larger sum can be
allowed than has-been previously done, it is taken into
consideration whether the lunatic is able to enjoy greater
comforts.
Evidence must be given of the retirement or death
of the committee, and of the fitness of the proposed suc-
cessor. The Master will sometimes require the com-
mittee to personally appear before him, and. require
evidence of his willingness to act and visit the patient
at stated times; and evidence must be given that he is
a fit person to superintend the person or estate of the
lunatie..
Death of the Lunatic.
If the will has been deposited at the Master’s office,
he is empowered to open it; and having ascertained
whether any particulars are therein directed relative to
the interment, and who the executors are, it will be
deposited in the Court of Probate.
The Masters, on being satisfied of a lunatic’s death,
may, without order, open and read any paper deposited
at their office purporting or alleged to be the will, in
order to ascertain who is therein nominated executor,
and whether there are any and what directions con-
cerning the funeral or place of interment, and after-
wards deliver the same to the Registrar or other officer
of the Court of Probate.
Before the Master will return any papers or docu-
ments which have been deposited at his office, he must
have a statement of facts placed before him showing.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 131
the nature of the said documents, the interest which
the lunatic had in them, and who is entitled to them.
The Master will draw up his report, and it is filed
with the Registrar for confirmation. If a special order
is obtained for this purpose, a copy of it is left with the
Master, and a summons taken out for comparing the
deeds with the schedule of them.
This examination having been made, the papers and
deeds will be delivered over as directed.
If the person to whom an order has been given for ee
the delivering of the doeuments is unable to attend in up the
* c * ‘ Iunatic's
person to receive them, he must give a written authority documents.
to some person to act for him; and his signature must
be sworn to by two witnesses, one of whom is required
by affidavit to identify the person giving the authority
with the person named in the order to receive the docu-
ments, and prove the signatures of such person, and the
witnesses’ also.
The person to whom this authority is given must
attend in person and give a proper receipt for them.
As mentioned before, the Crown, on the death of the
Innatie, renders back the estate to those members of his
family who are entitled to it, and has no further juris-
diction in the affairs of the late lunatic.
Proceedings necessary when the property does not exceed.
1,0001., or the income is not more than 501. per annum.
' I have considered, in the first part of this chapter, the
necessary steps to be taken in dealing with the property
of Innatics that exceeds 1,0001., or is more than 501. per
annum.
I will now pass on briefly to consider the legal steps
to be pursued in dealing with the property of a lunatic
amounting to 1,0001., or not exceeding 501. per annum.
In section 12 of the Lunacy Regulation Act 1862,
we see—
“Where, by report, one of the Masters in Lunacy or Proceedings
x2 for dealing
with the
property of
fanatics not
exceeding
1,0002. or
501. per
annum.
Procedure,
132 MANUAL OF LUNACY
of the Commissioners in Lunacy, or by affidavit or other.
wise, it is established to the satisfaction of the Lord
Chancellor entrusted as aforesaid that any person is of
unsound mind and incapable of managing his affairs,
and that his: property does not exceed 1,000/. in value,
or that the income thereof does not exceed fifty pounds
per annum, the Lord Chancellor entrusted as aforesaid
may, without directing any enquiry under a commission
of lunacy, make such order as hé may consider expe-
dient for the purpose of rendering the property of such
person, or the income thereof, available for his main-
tenance or benefit, or for carrying on his trade or busi-
ness: Provided nevertheless that the alleged insane
person shall have such personal notice of the applica-
tion for such order as aforesaid as the Lord Chancellor
shall, by general order to be made as after mentioned,
direct.” /
In cases where the property is of the amount above-
mentioned no enquiry takes place before the Master, but
conclusive evidence of the invested property must be
given.
The mode of proceeding is as follows :—
If it be established to the satisfaction of the Lord
Chancellor, by medical affidavits or otherwise, that the
person is of unsound mind and incapable of managing
his own affairs, and that his property does not exceed
one thousand pounds, or his ineome fifty pounds per
annum, the Lord Chancellor can then make an order as
he may think proper for the purpose of rendering the
property of such person or the income thereof available
for the maintenance of the person.
The patient must have had a notice of the appli-
cation for such order.*
** 25 and 26 Vict. c. 86, 8, 12.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 133
Single Chancery Patients.
It is enacted that the person who undertakes the
care of a Chancery patient in his house for profit is
liable to the same responsibilities and duties as are en-
forced in the case of a single private patient.
If the committee takes care of the patient, he is not
affected by this clause.
The fortnightly visitation, as required in the case otf
private patients, is dispensed with.* The patient is
subject to visitation, both by the Commissioners in
Lunacy and also by the Lord Chancellor’s visitors..
Visitors of Chancery Lunatics.
All Chancery lunatics are visited once in every year,
and sometimes more frequently, by one or more of the
Lord Chancellor’s visitors, who report upon each case
separately to the Chancellor.
The Lord Chancellor’s visitors consist of one legal
and two medical visitors. The legal visitor is William
Norris Nicholson, Hsq.; the two medical visitors are
John Bucknill, Esq., M.D., and Lockhart Robertson,
Esq., M.D.
Their salary is 1,500]. per annum, exclusive of tra-
velling expenses.
The two Masters in Lunacy are, by virtue of their
appointments, visitors of lunatics.
The visitors are not allowed to engage in private
practice,
They at the time of their visit are furnished with a
statement of the income of the lunatic, the scheme of
allowance for maintenance, and they have to consider:
whether the means provided for the comfort are suf-
ficient for the sum allowed for the maintenance, and
that he hag such comforts as his mental condition and
* 25 and 26 Vict. c. 111, 8, 22.
Single
Chancery
patients.
Visitation of
Chancery
. patients.
Visitors may
order a
change in
the lunatic’s
residence.
‘Lunatics
possessing
property in
Treland.
Inquisition
and super-
sedeas may
be trans-
134 MANUAL OF LUNACY
income will allow of, or whether anything can be done
to further the enjoyment of the same, or any alteration
made in the scheme drawn up for his maintenance.
If the visitors are of opinion that a change in any of
these respects is desirable, the Board, having considered
the matter, will take such steps as appear necessary, or
the visitors may refer to the Masters, who, having in-
vestigated it, will summon the committee before them
to give any explanation that may be required.*
No person shall be appointed to be a visitor if he is,
or has been within two years preceding his appointment,
interested directly or indirectly in an asylum, and if
any of the visitors becomes after his appointment so in-
terested, his appointment as visitor shall ¢pso facto cease.
The visitors hold their appointment during their good
behaviour, and may be removed therefrom by the Lord
Chancellor in case of misconduct or neglect of duty.
Inmatics not within the Jurisdiction of the Court.
A lunatic residing in England, in which country an
inquisition has been held, but whose property is in Ireland,
a committee of the person and estate is nevertheless ap-
pointed by the Lord Chancellor of England in the same
way as if the lunatic’s property was in England.
A copy of the inquisition is ordered to be sent to
Ireland, and proceedings are taken-out in the Irish
Chancery Court with reference to his estates and the
sum allowed for maintenance as if he were residing in,
Ireland.
‘“* Where it is desired that an inquisition taken on a
commission issued under, or a writ of supersedeas thereof
issued under, the great seal of the United Kingdom, or
under the great sealof Ireland respectively, should be
* The visitors have no legal power to authorise the discharge
of a Chancery patient ; they can only recommend his removal to the
Committee and to the Lord Chancellor.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 135
acted upon in Ireland or in England respectively, the
proper officer ‘may, under order of the Lord Chancellor
of Great Britain or the Lord Chancellor of Ireland, as
the case may be, transmit a transcript of the record of
the inquisition, or of the writ to the Chancery of ‘Ireland
or of England, as the case may be, which transcript
shall thereupon be entered, and be of record there re-
spectively, and shall when so entered of record, and if,
and so long only, as the Lord Chancellor of Ireland en-
trusted as aforesaid, and the Lord Chancellor of Great
Britain entrusted as aforesaid, as the case may be, shall
see fit, may be acted upon by them respectively, and be
of the same validity and effect to all intents and pur-
poses as if the inquisition had been taken on a com-
mission issued under, or the writ of suwpersedeas had been
issued under, the great seal of Ireland, or of the United
Kingdom respectively.’’ *
Similar proceedings are adopted when the lunatic
resides in Ireland, and the inquisition is held there, but
has property in England.
The Lord Chancellor is generally unwilling to admit
a lunatic, found so by inquisition, to reside out of the
jurisdiction of the Court.
Nevertheless, sometimes in exceptional cases, when
it has been clearly established that a change of residence
is for the lunatic’s benefit, permission is given for re-
moval to Scotland or Ireland, bat in a case like this the
committee is required to bring the lunatic within, the
jurisdiction of the Court at such a time and place as
may be directed, and also to send periodical reports
- respecting the lunatic’s bodily and mental state, and to
comply with any other directions made by the Court.
Mr. Dyce Sombre was allowed, after being found
lunatic by inquisition, to reside in Paris.
* 16 and 17 Vict. c. 70, 3. 52.
mitted from
and to Ire-
land and
England,
and be acted
upon there
respectively.
Lunatics
permitted
occasionally
to reside
beyond the ~
jurisdiction
of the Court.
Proceedings
necessary
for obtaining
& superse-
deas.
136 MANUAL OF LUNACY
« Supersedeas’ of the Inquisition.
When a person has been found lunatic by inquisition
and the question of mental unsoundness is disputed, a
supersedeas way be applied for.
A petition accompanied with medical and other evi-
dence of the recovery must be left with the Registrar,
and a copy of the petition endorsed with the order for
hearing be delivered to the committees and next of kin.
The Lord Chancellor having appointed a day for.
hearing the application personally examines the lunatic
either at the hearing of the petition or at some other
appointed time. Except under very special circumstances
the personal examination of the lunatic is indispensable.
If the Lord Chancellor is satisfied that the lunatic
has recovered, an order for the swpersedeas and the writ
of supersedeas resulting thereupon are drawn up by the
Registrar in the usual way.
WRIT OF SUPERSEDEAS OF COMMISSION (or Fut)
AND INQUISITION.
Victoria, by the Grace of God, of the United Pepto: of Great
Britain and Ireland, Queen, Defender of the Faith.
To all to whom these our present Letters shall come Greeting.
Whereas, by a certain Inquisition taken at, &., on, &c., by virtue,
&c., in that behalf duly made and issued to enquire amongst other
things of the lunacy of A. B., of, &c., it was found (amongst other
things) that the said A. B., at the time of taking the said Inquisition,
was a person of unsound mind, so that he was not sufficient for the
government of himself and his estate, as by the same Inquisition
(amongst other things) remaining on record may more fully appear.
But upon full examination in our Court of Chancery before'us, had
in this behalf, it sufficiently appears to us, that the said/A. B. is
recovered of his unsoundness of mind aforesaid, and is of sound
mind, memory, and understanding, so that he is sufficiert for the
government of himself and his estate.
And we in this behalf being willing that what is justand right
be done to the said A. B.: Know ye, therefore, that yé, for and
in consideration that the said A. B. now is not lunatic, but of
sound mind, sane memory, and understanding, and for divers other
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 137
good causes and considerations, us in this behalf especially moving,
Have superseded and determined, and by these presents Do supersede
and determine the aforesaid Commission (or, &c.), &c., the afore-
said Inquisition, and all other proceedings thereupon had and made,
and all and singular the same, to all intents and purposes whatso-
ever, we annul, make void, and fully discharge by these presents.
In testimony whereot we have caused these our Letters to be made
Patent. ,
Witness ourself at. Westminster the day of
in the year of our reign.
The Lord Chancellor is empowered to supersede an
inquisition upon certain terms and conditions; this is
done when the Lord Chancellor is of opinion that it is
not for the benefit of the lunatic for the commission to
be superseded unconditionally. He must first obtain the
consent of the lunatic and also of other persons whom
the Lord Chancellor may think necessary.
If the Lord Chancellor think proper, instead of im-
mediately superseding the commission he may for a
time suspend the proceedings under it in order to test
the effect of removing the previous surveillance.
Traverse of Inquisition.
Any person who is desirous to traverse the inquisi-
tion is required to present a petition within three months
from the time of its being held.
The case is heard within six months from the date
of the petition ; the petition is presented to the Regis-
trar, and having been answered in the usual way is set
down for hearing before the Lord Chancellor, who will
appoint a time for examining the lunatic, adopting such
a course as he may think proper.
No person is allowed to traverse more than once.
Notice of the trial is given by the solicitor, and the case
is heard at the next assizes, either in the county where
the inquisition was held, or in which the petitioner is
then residing, as the Chancellor may direct.
Proceedings
necessary for
traverse,
Only one
traverse is
allowed.
Form of
petition for
traverse.
138 MANUAL OF LUNACY
If the verdict is against the lunatic, the result of the
inquisition remains the same, and committees are ap-
pointed in the usual manner; but if, on the other hand,
the verdict is for the lunatic, proceedings are immediately
taken for restoring the patient to the enjoyment of his
liberty and rights.
I give a form of petition for traverse presented by the
lunatic. This must be accompanied by medical affi-
davits of his mental condition and capacity to manage
his affairs.
FORM OF PROCEEDINGS AS TO A TRAVERSE,
Petition FoR Leave To Traverse Inquisition.
In the matter of 0. E. W., a person found to be of unsound mind.
To the Right Honourable the Lord High Chancellor of Great
Britain, ;
The humble petition of the said O. E. W. showeth,
That by an Order for Inquiry made in this matter on, &c., it
was ordered that, &c., should enquire of the lunacy of your peti-
tioner.
That by the Inquisition taken on the execution of the said
Order on, &c., it was found that your petitioner was a person of
unsound rind, &e.
That your petitioner has been informed, and believes. ‘that
(state grounds of Traverse).
That your petitioner is advised that the said finding was con-
trary to the evidence adduced on the-part of your petitioner.
That your petitioner is greatly aggrieved and prejudiced by the
issuing of the said Fiat (or Commission), and the return of the said
Inquisition.
And that your petitioner is of sound mind, and perfectly com-
petent to the government of himself and his property.
That the proceedings to appoint committees of the person and
estate of your petitioner, and to enquire who are the heir-at-law
and next of kin of your petitioner, and other matters under the
General Orders in Lunacy are now pending before the Master in
Lunacy.
Your petitioner, therefore, humbly prays your Lordship that he
may be at liberty to traverse the aforesaid Inquisition, and that
your Lordship will stay in the meantime all further proceedings
going before the Master.
COMMISSIONS IN LUNACY, AND CHANCERY LUNATICS 139
Or that your’ Lordship will be pleased to make such further or
other order in the premises as to your Lordship shall seem just.
And your petitioner will ever pray, &c,
Signature of petitioner
Witness to the signing hereof
By the said O. E. W.
J. B., of Solicitor,
Answer.
(Date.) Let all persons concerned attend me on the matter of this
petition on next, the instant, hereof give
notice forthwith.
‘
Admission of Chancery Patients into Licensed Houses.
A person who has been found of unsound mind by
inquisition can be received into an asylum* without
medical certificates. ‘An ‘ Order’ signed by the Com-
mittee appointed by the Loyd Chancellor, and having
an office copy of such appointment annexed, is a sufficient
authority for his reception into any hospital or licensed
house without any further order or medical certificate.”’
I cannot conclude this chapter without acknow-
ledging the great assistance I have derived from
Elmer’s Practice in Lunacy in enabling me to arrange
concisely the facts I have mentioned in connection with
Commissions in Lunacy and Chancery lunatics, and I
strongly recommend all who are interested in this
subject, or who desire more information than I have
given, to carefully peruse the pages of this valuable
work.
* Removal, Change of Address, Visits to the Seaside, §c., §e.—
The Committee of the person, or any person in whose private
house, or asylum, a Chancery lunatic resides, is required to send
notice to this office, three days previous to any intended change of
residence, of the exact address where the patient is to be found. A
similar notice three days before the return home is also to be sent.
Such notices are to be posted unpaid, addressed ‘‘ Lunatics Visitors’
Office, 45 Lincoln’s Inn Fields, London, W.C.”
By order of the Board,
Easton Cox, Secretary.
No certifi-
cates re-
quired
- previous to
the admis-
sion of
Chancery
patients into
asylums.
Prelimi-
naries
previous to
admission.
140 MANUAL OF LUNACY
CHAPTER IX.
REGULATIONS RESPECTING THE ADMISSION OF PATIENTS INTO
ST. LUKE’S HOSPITAL AND BETHLEHEM HOSPITAL.
St. Luke’s Hospital for Lunatics.
Tus hospital is situated in’ Old Street, in the parish
of St. Luke’s, and is exclusively for private patients
who are unable to avail themselves of the advantages: of
a private asylum. The average number of patients du-
ring the year 1871 was 144; of this number 93 were
females, and 51 males. The total number of patients
admitted during the year 1871 was 24 males, and 45
females. The number discharged was 35 males, and 62
females ; and out of this number 16 males and 32 females
were discharged as “ recovered.”
In order to obtain admission into this hospital it will
be necessary for a friend or relative of a patient to go
to St. Luke’s, and he will then procure a form of ad-
mission, containing the order, statement, and medical
certificates ; these have to be properly filled up and
signed before the patient can be received. The form
of admission is nearly the same as that required for an
ordinary patient ; but there are a few additional facts to
be stated, for the guidance of the authorities of the
hospital.
Patients have to be presented to the Board for ad-
mission on Friday morning, at half-past ten, with the
form of admission properly filled up, as mentioned in the
preceding paragraph. If this is satisfactory, the patient
will be admitted ; but the medical officer of the hospital
ST. LUKE’S HOSPITAL, 141
has the power to receive a patient on any day, if the case
be an urgent one and the certificates are correct. The
patient being then only received conditionally, the Board
at their meeting must formally sanction the admission
before the patient is considered as duly admitted.
At the last visit of the Commissioners in Lunacy to Number on
this hospital there were 156 patients on the books. Of! ommission-
this number 24 were maintained free of charge, 26 were eres
received at the rate of seven shillings per week, 19 re-
ceived at fourteen shillings per week, 56 at twenty-one
shillings per week, and 2 at thirty shillings. We see,
therefore, that the patients are’ charged according to
their means. Any case which the Board considers a
proper one is admitted free of all charge.
The medical superintendent is Dr. Hager, who is
always ready and willing to give any information re-
specting the hospital. 2%
The patients have the use of a billiard-room. They ARIE
have weekly entertainments, consisting of concerts and patients.
dances, at which those patients who are capable and in
a fit state are present.
ST. LUKE'S HOSPITAL, LONDON, E.C.*
187
As it will materially assist the Committee in their consideration
of the eligibility for admission or otherwise of the. patient on
whose ‘behalf you apply, and also tend to save the friends trouble
and expense, you or some of the friends or relations are requested
to furnish answers to the following questions, and forward them
to me.: ,
I am,
Your obedient Servant,
Grorcr SryMour,
Secretary,
To
ee
* This ‘must be sent to the Secretary previous to forwarding the
Certificates. :
142 MANUAL OF LUNACY
Name and Age.
Married
or Single
No. of
Children
Occupation
Degree of
Education
How long has Patient been
Insane?. . 2. we
Is this the first attack? if
not, how many previous at-
tacks? . 1... .
If previously under treatment
state as follows:
1. Where treated? .
2. In what year? . .
3. If discharged cured?
Mention the insane peculi-
arities of action or fancy
Is Patient
1. Noisy? a « 3% >
2. Dirtyin habits? . .
8. Destructive? . .
4, Suicidal? and how?
5. Violent to others?
Does Patient refuse food ? and!
if so, how long abstinent?
Does Patient sleep well? .
Does Patient suffer from any,
and ‘if so, what bodily ill-
NESS? ek we we
Is Patient subject to Fits of
Epilepsy? or if Paralytic’
BAYIEO)- ac ew
State previous habits of life .
Here state means of support
of Patient, or what amount
the Friends are ina position
to contribute towards the
Patient’s maintenance , ,
Name
Address
Business or Profession
ST. LUKE'S HOSPITAL. 143
SAINT LUKE'S HOSPITAL FOR LUNATICS.
ESTABLISHED A.D, 1751,
Instructions to Persons applying for the Admission of
Patients,
1—A Committee of Governors assembles at the Hospital every
Friday Morning, at Eleven o'clock precisely, for the purpose
of considering applications for the admission of Patients ; but
urgent cases are, subject to the approval of the Committee,
admissible during the week.
2.—All Insane Persons whose friends carnot afford to make any
payment, are eligible for admission free, except Chronic cases,
and the following, who are inadmissible under any circum~
stances :-—
a.—Persons in regular receipt of Parochial Relief, or who,
in the opinion of the Committee, are proper objects
for it.
B.—Idiots, Persons suffering from Epilepsy, from certain
forms of Paralysis, from Infectious Disease; being
pregnant ;.in a condition which threatens a speedy
dissolution of life; in a dirty state, or unprovided
with the requisite Clothing.
3.-—Persons who have been Insane for Twelve Months, or whose
cases are considered by the Committee to be Chronic, can only
be admitted on payment.
4.—The amount of payments, in ali cases, will be arranged by the
Committee.
Notice.—Every Person who, through mistake, misinformation, or
otherwise, shall have been received into the Hospital as a Patient,
shall be discharged therefrom immediately on a discovery of any
of the above disqualifications.
Special Directions.
The Order, Statement, and Medical Certificates, properly filled
up and signed, must, on Thursday, be forwarded to the Secretary at
the Hospital, and the nearest Relation or Friend, accompanied by
the Patient, must attend on Friday Morning, at Half-past Ten
o'clock at latest, to be examined respecting the Case; and the Com-
mittee will then admit the Patient, if a fit object.
N.B.—The Medical Certificates will be invalid, if not filled up
in strict accordance with the printed instructions.
144
MANUAL OF LUNACY
Clothing.—Every Patient must, on admission, be provided with
articles of apparel, according to the List subjoined, and the same
must be kept supplied from time to time as required :—
FOR A MALE PATIENT.
1 Coat,
1 Waistcoat, onder Suit.
1 Pair Trousers,
1 Coat, Working, or
1 Waistcoat, \avory-aey
1 Pair Trousers, J Suit.
1 Pair Braces.
6 Day Shirts.
3 Night Shirts.
6 Pocket Handkerchiefs (cotton).
2 Neck Ties.
4 Pairs of Socks.
2 Pairs of Shoes or Boots, with-
out tips and nails,
2 Pairs Flannel
Drawers, If worn
2 Night Caps, usually by
2 Flannel Waist- ‘the Patient.
coats, t
1 Hat.
1 Cap.
4 Chamber Towels.
1 Hair Brush and Comb.
1 Pair Leather Slippers, with-
out heels or nails.
6 Collars.
FOR A FEMALE PATIENT.
4 Long Night-gowns.
4 Night Caps.
2 Day Caps or Head Dresses.
4 Chemises.
2 Flannel Petticoats.
2 Stuff Upper Petticoats.
1 Pair of Stays.
4 Pairs of White Stockings.
6 Handkerchiefs.
4 Collars.
2 Black Aprons.
3 Dresses.
1 Shawl.
1 Bonnet.
2 Flannel Waist-) If worn
coats, bay by
4 Pairs Drawers, J the Patient.
2 Pairs of Shoes or Boots.
4 Chamber Towels.
1 Hair Brush and Comb.
6 Diapers.
4 Bodices.
Two substantial Housekeepers must bind, themselves by Bond,
in the penalty of One Hundred Pounds, to make such Weekly Pay-
ment for the Patient as may be arranged; to provide sufficient
Linen and Clothing; to pay for all damage done by the Patient
whilst in the Hospital ; and to remove the Patient from the Hospital
on Seven Days’ notice.
*,* It being very important in the treatment of insanity gene-
rally, and conducive to the recovery of those afflicted with that
distressing malady, that the physical condition of the Brain, as well
as the cause of the disorder, should be ascertained, in cases of
death,—the Committee have directed that, should a Patient die
while in the Hospital, the Medical Officers of the Establishment be
‘ST, LUKE'S HOSPITAL 145
authorised to examine the body, unless an objection shall have been
made in writing to the Secretary previous to the decease of such
patient,
N.B.—The following Order and Statement must be very carefully
Silled up by a Relative or Friend of the Patient.
“ORDER” FOR THE RECEPTION OF A PRIVATE
PATIENT,
L, the undersigned, hereby request you to receive
whom I last saw at
(a) on the day of. (a) Within
a Lunatic, as a Patient into your Hospital. Subjoined is a one month
Statement respecting the said Vredate of
(Signed) Name,. .. pi eS ghe,order:
Occupation (if any)
Place of Abode
Degree of Relationship (if 7
any) or other circumstances
of connection with the Pa-
tient rn ’ °.
Dated this__ day of____ One Thousand
Eight Hundred and Seventy
To the President, Vice-Presidents, Treasurer, and Governors
of St. Luxe’s Hosrrtaz for Lunatics, London.
* STATEMENT.”
If any particulars in this Statement be not known, the Fact to be so
stated.
Name of Patient, with Christian name aty
length . ‘ ‘ . ‘ a |
Sexandage . . 3
Married, Single, or Widowed :
Condition of life, and ‘a San.
(if any) .
The religious persuasion, | as far as known
Previous place of abode’ .
Whether first attack .
Age (if known) on first ita
When and where previously under cand.
and treatment . : . .
L
146 MANUAL OF LUNACY
Duration of existing attack . . .
Supposed cause... .
Whether subject to Epilepsy :
Whether Suicidal . . . :
Whether Dangerous to others ; : -
Whether found Lunatie by Inquisition,
and date of Commission or order io
Inguisition . A
Special circumstances (if any) preventing
the Patient ‘being examined before
admission, separately by two Medical
Practitioners
Name and Address of Rlative to whew
Notice of Death to be sent
How many previous attacks? .
Have any Relatives of the Family Both
similarly affected? . }
State in what degree of relationship .
Has the Patient been of sober habits? .
Number of Children’? (4f oy)
Age of youngest? , ‘
Degree of Education ? ‘i . .
(e) Where the person i
signing the statement is (Sign ed) Name, (¢)
not the person who signs Occupation (if any)
the order, the following i
particulars concerning the Place of Abode. : SSS
person signing the state- Degree of Relationship (if
on meee eeaaed: any) or other circum-
stances of connection with
the Patient j .
.
Neen en nn
The Medical, Gentlemen certifying, must not be Assistant one to
the other, nor in Partnership with each other, nor in Partnership
with, nor nearly related to, the Person signing the annexed Order.
They are required to state the Facts on which their Opinion has
been formed, ¢e.g.: delusions (specifying the nature of the delusions),
incoherence, imbecility, fatuity, alteration of conduct and affections,
dirty habits, &c., and the Certificates must not have reference to
each other,
N.B.—It is indispensably necessary that the Patient be brought
to the Hospital for admission within Seven’ Days from the date of
signature of the Medical Certificates, or the Patient cannot be re-
ceived except upon new Certificates; and a Statement of the
Patient’s Case from one of the Medical Gentlemen who has attended
ST. LUKE’s
HOSPITAL 147
the Patient, should be sent to the Hospital, directed to “ Dr. Monro,”
or “Dr. Wood” (the Physicians), previous to the admission of the
Patient.
Should either of the Medical
Certificates be signed by mem-
bers of the profession not on the
last issued Medical Register, it
will be necessary to afford evi-
dence to the Secretary, that they
have subsequently duly regis-
tered, otherwise the Certificate
will be illegal.
(See Clause 37—21 & 22
Vict., Cap. 90.)
A Medical Certificate is in-
valid if there be not inserted
therein “the Street and Number
of the House (if any) or other
like particulars” where the Pa-
tient was examined.
[See Mr. Justice Coleridge’s
decision ix re Greenwood, 12th
February, 1855.]
FIRST MEDICAL CERTIFICATE,
* ae I, the undersigned, being a *
Cli . a 7 =
Tegal asi and being in actual practice as a
fication to
practise, &c.
day of 18
in the County of
* State oc- of § a*
eupation of .
patient. the said
hereby Certify, that I, on the
, Separately from any other
Medical Practitioner, personally examined
proper Person to be taken charge of, and
detained under care and treatment: and that I have
formed this opinion upon the following grounds, viz :—
+ qualification
,att
ss apothecary,
and that ™ay be.
is a Lunatic, and a
ticulars.
any.
1. Facts indicating Insanity observed by myself,—
2. Other facts (if any) indicating Insanity communicated to
mebyY .
(Signed),
Place of Abode
_ Dated this___— day of 18 .
L2
* Here ‘set forth the
entitling the
person certifying to prac-
tise as a physician, surgeon,
or apothecary, ex. gra. being
@ Fellow of the Royal College’
of Physicians in London.
t Physician, surgeon, or
as the case
t Here insert the street
and No. of the house (if
any), or other like par-
§ Insert residence and
profession or occupation, if
Here state
the facts.
Here state
the infor-
mation, and
from whom.
{ Christian
‘and surname
of informant
must be
given here,
* Here set forth the
qualification entitling the
person certifying to prac-
tise as a physician, surgeon,
or apothecary, ex. gra. being
a Fellow of the Royal College
of Physicians in London.
t Physician, surgeon, or
Spothecary, as the case may
re.
} Here insert the street
and No. of the house (if
any), or other like par-
ticulars.
§ Insert residence and
profession or occupation, if
any.
MANUAL OF LUNACY”
SECOND MEDICAL CERTIFICATE,
I, the undersigned, being a* oe here
and being in actual practice as a t legal ean
i cation to
hereby Certify, that I, on the pructing, be,
day of 18, att
in the County of , separately from any other
Medical Practitioner, personally examined
of § a* and that * State oc-
the said - is a Lunatic, and a ee -
proper Person to be taken charge of, and
detained under care and treatment: and that I have
formed this opinion upon the following grounds, yiz:—
1, Facts indicating Insanity, observed by myself,—
Here state
the facts.
Here state
the infor-
mation, and ne: by q
from whom.
2. Other facts (if any) indicating Insanity, communicated to
gq Christian
and surname
of informant
must be
given here.
Dated this
(Signed)
Place of Abode
day of.
18
Ido hereby certify that the above-named
is NoT in the receipt of Parochial Relief or Alms from his (or her)
Parish.
To be Signed by the Overseer, or Relieving Officer
I, the undersigned, a Governor of Saryt Luxe’s Hosprvat, desire
the said Lunatic may be admitted if a fit Object.
[This is sent] “ To the Secretary, St. Luke’s Hospital, Old Street,
London, E.C.”
ST. LUKE'S HOSPITAL 149
BOND.
Know all Men vy these Presents That We (')
OLS(2)i eg
‘ ; in the County of__-
SLY
of (5)
in the County of (*)
are jointly and severally held and firmly bound, as Principals, to
the President, Vice-Presidents, Treasurer, and Governors of Saint
Luke’s Hospital (hereinafter mentioned or referred to as “the said
Corporation” ), in the sum of one hundred pounds of lawful money
of Great Britain, to be paid to the said Corporation, or their certain
Attorney, Successors, or Assigns, for which payment, to be well and
faithfully made, we bind ourselves, and each of us, as Principals,
our and each of our heirs, executors, and administrators, firmly by
these Presents, sealed with our Seals. Dated this
day of in the year of our Lord One
thousand eight hundred and seventy
Whereas
of in the County of
hereinafter called or referred to as “the said Lunatic,” was, on the
day of 187, received as a Patient into the
Hospital of the said Corporation, known as St. Luke’s Hospital,
situate in Old Street, St. Luke’s, in the County of Middlesex, upon
the condition of our entering into the above Bond subject to the
conditions hereinafter set forth. Now therefore the Condition of the
above written Bond or Obligation is such that if we or either of us
do and shall from time to time, during all the time in which the
said Lunatic shall continue to be an inmate of the said Hospital,
well and traly pay, or cause to be paid, unto the said Corporation,
or unto the Treasurer for the time being of the said Corporation,
money at the rate or scale of shillings per week as and by
way of contribution towards the board and maintenance of the said
Lunatic during h continuance in the said Hospital, the same to
be always paid in advance at that rate by payments at intervals of
four weeks each, the first payment thereof to commence and be
made on the day of 187. : And also if we
or either of us shall, from time to time, find and provide, and keep.
supplied, for the said Lunatic, sufficient and decent linen and cloth-.
(1) Namd¢ of
first bonds-
man,
(2) His ad-
dress.
(3) His
occupation.
(4) Name of
second
bondsman.
(5) His ad-
dress.
(6) His
occupation.
(A) First
bondsman to
sign here.
(c) Witness
to sign here.
(B) Second
bondsman
to sign here.
(D) Witness
to sign here,
150 MANUAL OF LUNACY
ing, according to the list set out in the Schedule hereto, during all
the time that h continues a Patient in the said Hospital,
or shall, from time to time, on demand in writing signed by the
Treasurer or the Secretary for the time being of the said Corpora-
tion, and left at the last or last known place of abode or of business
of us, or of either of us, repay unto the said Corporation or unto
the Treasurer for the time being of the said Corporation, all such
moneys as may have been from time to time expended by the said
Corporation in providing and supplying such sufficient and decent
linen and clothing as aforesaid, for the said Lunatic whilst a patient
in the said Hospital: -And also if we or either of us do and shall
from time to time, on demand in writing, signed by the Treasurer or
the Secretary for the time being of the said Corporation, and left at
the last or last known place of abode or of business of us, or of
either of us, pay unto the said Corporation or unto the Treasurer
for the time being of the said Corporation, all the costs, outlay,
and expenses from time to time incurred by the said Corporation in
reinstating, repairing, or otherwise making good all furniture,
bedding or other clothing, glass, china, or other property of the said
Corporation, which may at any time or times be destroyed, torn,
broken, or otherwise damaged by the said Lunatic during h stay
in the said Hospital: And also if we or either of us do and shall
within seven days next after we or either of us shall be thereunto
required by notice in writing, signed by the Treasurer or the Secre-
tary for the time being of the said Corporation, and left at the last
or last known place of abode or of business of us, or of either
of us, remove and take away the said Lunatic from the said
Hospital, at our, or one of our, costs and charges: Then the above
obligation shall be void.
The above Bond was signed, sealed,
and delivered by the above named
First Bondsman in my presence ;
and I do hereby certify that the (a)
said First Bondsman is known to
meas a respectable Housekeeper.
(c)
The above Bond was signed, sealed,
and delivered by the above named
Second Bondsman in my presence;
and Ido hereby erie that the (8)
said Second Bondsman is known |-
tome as arespectable Housekeeper.
(2)
ST. LUKE'S
The Schedule referred
Bond :—
Croruzs For A Mare Patient.
1 Coat,
1 Waistcoat,
} Sunday Suit.
1 Pair Trousers,
1 Coat, Working or
1 Waistcoat, } Every-day
1 Pair Trousers, Suit.
1 Pair Braces.
6 Day Shirts.
3 Night Shirts.
6 Pocket Handkerchiefs,
2 Neckties,
4 Pairs Socks.
2 Pairs of Shoes, or Boots,
without tips or nails.
2 Pairs Flannel)
Drawers, worn usu-
2 Night Caps, ally by the
2 Flannel Patient.
Waistcoats,
1 Hat.
1 Cap.
4 Chamber Towels.
1 Hair Brush and Comb.
1 Pair Leather Slippers.
6 Collars.
HOSPITAL 151
to in the above-written
Crores ror A FEMALE Patient.
4 Long Night-gowns.
4 Night Caps,
2 Day Caps or Head Dresses.
4 Chemises.
2 Flannel Petticoats.
2 Stuff Upper Petticoats.
1 Pair of Stays.
4 Pairs of White Stockings.
6 Handkerchiefs.
4 Collars.
2 Black Aprons.
3 Dresses.
- 1 Shawl.
1 Bonnet.
: If worn
2 sca Waist- usually
2
4 Pairs Drawers, hae
2 Pairs of Shoes or Boots.
4 Chamber Towels.
1 Hair Brush and Comb:
6 Diapers.
4 Bodices.
Admissions
during the
year.
152 MANUAL OF LUNACY
BETHLEHEM HOSPITAL.
Bethlehem Hospital is situated in the St. George’s
Road, Lambeth, in the county of Surrey. It contains
on an average about 270 patients, of both sexes.
At the time of the Commissioners’ visit in 1871, the
number on the books was 258, classified as follows :—
— Males | Females | Total
Curables . . 0. 0. 88 | 114 | 202
Incurables ‘ , F ‘i 25 30 55
Criminals , os ¢ ‘ F _ 1 1
Total . ‘ ‘ ‘ 113 145 258
The admissions during the year were 76 male and
‘128 female patients, the discharges 201, out of which
number 37 males and 72 females were discharged
recovered. ;
Dr. W. R. Williams, the resident medical officer, is
always willing td give any information respecting the
hospital, and does all in his power to promote the com-
fort and happiness of his patients.
INSTRUCTIONS FOR PERSONS APPLYING FOR THE AD-
MISSION OF PATIENTS INTO BETHLEHEM HOSPITAL.
1, All poor lunatics, presumed to be curable, are eligible for ad-
‘mission into this hospital, for maintenance and medical treatment,
except—
1, Those who have sufficient means for their suitable maintenance
in a Private Asylum,
2. Those who have been Insane more than twelve months, and are
considered by the Resident Physician to be Incurable.
3. Those who are in a state of Idiocy, or are subject to Epileptic
Fits, or whose condition threatens the speedy dissolution of life, or
requires the permanent and exclusive attendance of a Nurse.
BETHLEHEM HOSPITAL 153
N.B.—“ A preference will be given to Patients of the educated
classes—to secure accommodation for whom, no Patient will be re-
ceived who is a proper object for admission into a County Lunatic
Asylum.”
Certificate to be signed by the Minister and Parish Officers,
and also by some Relation or Friend of the Lunatic.
We whose Names are hereunder subscribed, being the Minister
and the Churchwarden, or the Overseer of the Parish of
t Here in-
sert the
degree of
relationship
(if any).
t Here in-
sert whether
the lunatic
has or hag
“not received
parochial
support.
in the County of and *
of the Parish of in the
County of the f.
of in whose behalf the pre-
sent petition is presented, having carefully read over
the foregoing Three Regulations, and the annexed
Certificates signed by Medical Practitioners, do hereby
Certify to the best of our knowledge and belief, that
who has resided in
this Parish for or upwards
now last past, is a Lunatic, and has +
received Alms from such Parish—is not in any of
the states or conditions above named—but is in every
respect a proper object for Bethlehem Hospital. And
humbly pray that the said
Lunatic, who is Years of Age, who has
been disordered in Senses —————s Months
and no longer, may be admitted into the said Hospital
for Medical treatment.
Witness our hands, this day of 18
} Minister.
Churchwarden
or
\ Overseer.
\ Relation or Friend,
I, the undersigned, a Governor of
Bethlehem Hospital, desire tha |
the above-named Lunatic may
be admitted, if a proper object.
* The pe-
titioner
must be as
near a re-
lation of
the lunatic
as possible,
but in ae-
fault of such
relation,
then some
friend of the
patient, or
officer of the
parish in
which such
patient re-
sides, will
suffice.
If the parties
do not hap-
pen to know
any gover-
_nor—this
signature
may be
omitted.
154 “MANUAL OF LUNACY
BOND.
Whereas petition hath been made to the Governors of Bethlehem
Hospital, for the admission of . .
as a Patient therein: Now we do hereby jointly and severally un-
dertake, promise, and agree, that in case the Lunatic above-named
shall be received as a Patient in the said Hospital, that we, or one
of us, will, within seven days next after we shall be thereto re-
quired, by notice in Writing, to be signed by the Steward for
the time being of the said Hospital, remove and take away the
said Lunatic from the said Hospital, at our, or one of our Costs
and Charges ; and at the like Costs and Charges bury such Luna-
tic, in the event of Death; and also that we, or one of us, will
pay to the said Steward the Costs and Charges of clothing the
said Lunatic, during the term of such Lunatic’s continuance in
the said Hospital. And in case of any default in the Premises,
we do hereby jointly and severally undertake, promise and agree
to pay to the Treasurer of the said Hospital for the time being,
the sum of One Hundred Pounds, on Demand, together with all
Costs of Suit to be incurred in respect thereof. As witness our
hands this day of
18
Signatures of the two Securities; Residence Occupation
I, the undersigned, the officiating Minister of the Parish of
, do hereby certify that the above signatures were made
in my presence; and that the parties so signing are respectable
Housekeepers residing in this Parish
The following is a List of the several Articles of Clothing re-
quired to be brought for the use of the Patient ; and the Friends of
the Patient will take notice, that, during the abode of the Patient
in the Hospital, they are not to furnish any further Articles of
Clothing unless by the written request or permission of the Steward
or Matron. The Friends of the Patient are also strictly prohibited
from giving Money to the Servants, to purchase any Articles of Cloth-
ing for the Patient; and they are not to offer or give any Fee,
Gratuity, or present to any of the Servants under any pretence what-
ever. The infringement of these Regulations will involve not only
BETHLEHEM HOSPITAL
155
the dismissal of the Servant, but the discharge of the Patient from
the Hospital.
eee oo oo Go Go bo eo bo GO Dee Hee Articles
: ‘ ; Required -
> 2 3
For Male Patient 2 3 For Female Patient
4g
Coat 2 | Night-gowns
Waistcoat Sunday suit | 2 | Night-caps
Pair of trousers 2 | Day caps
Coat Working or | 4 Shifts i
Waistcoat eeeryiey ree petucaats
Pairs of trousers suit Eyer pala
1 | Pair of stays
Shirts 3 | Pairs of stockings
Pocket handkerchiefs (cotton) | 3 | Handkerchiefs
Neckerchiefs or stocks 2 | Neckerchiefs
Pairs of stockings 2 | Aprons
Pairs of shoes or boots 2 | Gowns
Nightcaps If worn] 1 | Shawl
Flannel waistcoats | uspally| 1 Bonnet ‘
Pairs of flannel { by the | 2 | Flannel If worn
drawers patient waistcoats | usually
Night shirts 2 | Pairs of{ by the
Hat drawers patient
Garden cap or hat 2 | Pairsof shoesor boots
Pair of thin shoes or slippers
N.B.—When the Petition, Bond, and Certificates shall have been
filled up, and answers written to the following enquiries in the
« Statement,” this Paper must be forwarded to the Resident, Phy-
sician of Bethlehem Hospital, and notice will be returned when the
Patient may be brought up for examination, at which time the
Patient must be accompanied by some relative or friend able to
give information as to the circumstances and previous history of the
case.
156 MANUAL OF LUNACY
N.B.—Under all circumstances the “ Order”? and “ Statement” below
to Le filled up by the Patient's Relatives or Friends.
Tnnatics “ORDER” FOR THE RECEPTION OF A PRIVATE
16
Vict. 96.) PATIENT.
PATIGNT. Sched. (A) No. 1, Sects. 4, 8.
J, the undersigned, hereby request you to receive
whom I last saw at
(a) Wiebe ce anoiity on the (@) day of. 18
Bee ne eae UES gtd) as a Patient into your Hospital.
(0) Lunatic, or an idiot, Subjoined is a Statement respecting the said
or a person of unsound ;
mind. (Signed) Name,
Occupation (if any)
Place of Abcde
Degree of Relationship (if ‘on
or other circumstances of con=——@- a
nection with the Patient
Dated this day of
One Thousand Eight Hundred and ¢
To the
Superintendent of
Bethlehem Hospital, St. George's Road, Lambeth, 8.
“ STATEMENT.”
If any Particulars in this Statement be not known, the Fact to be so
stated.
Name of Patient, with Christian me
at length . : : ;
Sex and age . . .
Married, single, or widowed 3 5
Condition of Life, and previous occupa- 1
tion (ifany) . : : : SS
Religious Persuasion, as faras known .
Previous Place of Abode : .
Whether First Attack: . . . :
Ago (if known) on First Attack . .
When and where previously under rt :
and Treatment . . . .
Duration of existing Attack . . .
Supposed cause. ‘
Whether subject to Epileney 2
BETHLEHEM HOSPITAL 157
Whether suicidal .
Whether dangerous to others :
Whether found lunatic by Inquisition, }
and Date of Commission, or Order
for Inquisition .
Special Circumstances (if any) prevent-
ing the Patient being examined
before Admission, separately by Two
Medical Practitioners -
Name and Address of relative to whom
Notice of Death to be sent .
pi ts
How many previous attacks ? :
Have any relatives of the family been similarly affected ?
State in what degree of relationship.
Has the patient been of sober habits ?
Number of children ?
Age of youngest ?
Degree of education ?
(Signed) Name (e) () The “ Statement ”
: - must be signed, but where
Occupation (if any) the person signing the state-
Place of Abode ment is not the person who
J se signs the order, the follow-
Degree of Relationship (af any); | ing particulars’ concerning
: the person signing thestate-
or other cirowmstances of ment are to be added.
connection with the Patient
8 anp 9 Vicr, Car. 100, Sze, 45.
N.B,—Medical Certificates of Patient's Examination, and the
Signatures, are required, by the above Statute, to be dated within
Seven clear Days of the Patient's Reception.—In stating the Resi-
dence the number of the House must be specified, when there is
any.
The Medical Men signing the Certificates must not be in Partner-
ship, nor one an Assistant to the other.
By Order of the Commissioners in Lunacy.
1.—It is absolutely necessary that the Medical Men should write
their Certificates legibly, so as to afford the opportunity of an exact
copy being made.
9.— All alterations in the original Certificates, wnless by the
certifying Medical Men, invalidate them; and the initials of the
latter must be placed to every change r addition made.”
3. “If a Registered Medical Man describes himself as ‘A duly
qualified Registered Practitioner,’ it is not necessary that he should
specify his Medical Qualifications in full, in addition,”
158
Sched.
(a) Here set forth.the qualifi-
cation entitling the person cer-
tifying to practise as a physician,
surgeon, or apothecary, ex. gra, :
—Fellow of the Royal College of
Physicians in London.
(6) Physician, surgeon, or apo-
thecary, as the case may be,
(c) Here insert the street, and
number of the house (if any), or
other like particulars.
(d) A.B. of insert resi-
dence and profession, or occu-
pation (if any).
(e) Lunatic, or an idiot, or a
person of unsound mind.
(f) Here insert the facts. Some
definite fact or facts must be
specified, ,
Please to write the facts legibly,
and on the lines.
(g) Here state the information
and from whom received,
MANUAL OF LUNACY
MEDICAL CERTIFICATE.
(A) No. 2, Sects. 4, 5, 8, 10, 11, 12, 13.
I, the undersigned,
being a (a)
and being in actual practice as 4 (2)
hereby certify, that I, on the day of
18 at (c) Here insert the street,
and number of house (if any)
in the County of separately
from any other Medical Practitioner, personally
examined of (d) (State
address and occupation, if any)
and that the said isa (e)__
and a proper Person to be taken charge of and
detained under care and treatment, and that I
have formed this opinion upon the following
grounds; viz.:—
1, Facts indicating Insanity observed by my-
self (f) (Some definite fact or facts must be
specified)
2. Other facts (if any) indicating Insanity
communicated to me by others (g) (State the
name of the person giving the information)
(Signed) Name.
Place of Abode
Dated this day of
Thousand Eight Hundred and
One
BETHLEHEM HOSPITAL
MEDICAL CERTIFICATE.
159
Sched. (A) No. 2, Sects. 4, 5, 8, 10, 11, 12, 138.
I, the undersigned,
being a (a)
and being in actual practice as a (5)
hereby certify, that I, on the day of
18 at (c) Here insert the street,
and number of house (if any)
in the County of separately
from any other Medical Practitioner, personally
examined of (d) (State
address and occupation, if am)
and that the said_ is a (@)
and a proper Person to be taken charge of and
detained under care and treatment, and that I
have formed this opinion upon the following
grounds ; viz. :—
1. Facts indicating Insanity observed by
myself (f') (Some definite fact or facts must be
specified) :
2. Other facts (if any) indicating Insanity
communicated to me by others (g) (State the
name of the person giving the information)
(Signed) Name
Place of Abode
Dated this day of
Thousand Eight Hundred and
One
(a) Here set forth the qualifi-
cation entitling the person certi-
fying to practise as a physician,
surgeon, or apothecary, ex. gra. :
—Fellow of the Royal College of
Physicians in London.
(6) Physician, surgeon, or apo-
thecary, as the case may be.
(c) Here insert the street and
number of the house (if any), or
other like particulars.
(d) A. B. of insert resi-
dence and profession, or occupa-
tion (if any).
(e) Lunatic, or an idiot, or a
person of unsound mind.
(f) Here insert the facts. Some
definite fact or facts must be
specified.
Please to write the facts legibly,
and on the lines.
(g) Here state the information,
and from whom received.
Liabilities
of propries
tors and
medical
superin-
tendente.
160 MANUAL OF LUNACY
CHAPTER X.
LIABILITIES INCURRED BY THOSE CONCERNED IN THE CONFINE-
MENT OF PERSONS ALLEGED TO BE INSANE.
Ianorance of the law cannot be pleaded as an excuse for
its violation. Itis the duty of all persons who under.
take the responsibility of dealing with lunatics to make
themselves acquainted with the law relating to the con-
finement of the insane.
The plea usually set up in defence of an action
for infringement of the Lunacy Law is ignorance of the:
statute.
Inabilities of Proprietors and Medical Superintendents.
A proprietor or medical superintendent renders him-
self liable to an action for :—
1st. Receiving a patient without an order and medi-
cal certificates.
2nd. Admitting a patient into an asylum on an
order dated by a person who has not seen the patient
within one month from the date of his signing.
8rd. Receiving a patient on a medical certificate ‘in
which the examination of the patient was made more
than seven days prior to the admission.
The Commissioners in Lunacy are constantly impres-
sing upon the mind of proprietors of licensed houses
and asylums the great importance of carefully examin-
ing the various medical certificates and orders for ad-
mission before receiving the patient.
LIABILITIES INCURRED BY PROPRIETORS 161
Infringement of the Law by receiving a Patient without an
Order, Statement, and Certificates.
* The Commissioners were informed by the relieving
officer of the Taunton Union that two persons of un-
sound mind were taken care of for profit by a certain
Mr. D. at Langaller, near Taunton.
An order was received from the Lord Chancellor,t
and two members of the Board of Commissioners went
to Taunton, and, accompanied by the relieving officer,
enteréd the house of Mr. D.
One of the patients was found to be of weak mind,
but not sufficiently insane to necessitate being placed
under medical certificate.
The other patient was undoubtedly of unsound mind,
suffering from chronic dementia and delusions.
The state of this patient’s mind was quite apparent,
and nobody in the house attempted to dispute or disguise
this point. Upon further enquiry it was discovered that
be had been residing with his daughter up to August
1869, but on finding that she could no longer manage
him she applied to Mr. D., who agreed to take charge of
him.
The room in which he slept was found, with the
exception of .a tin pan for ‘water, quite destitute of
furniture.
The.Commissioners reported that Mr. D., having taken
charge of a lunatic gentleman for. prcfit, without the
order, statement, and certificates, as required by law, had
rendered himself liable to prosecution under the Lunacy
Acts, and they desired very strongly to express their
opinion that it was a case in which proceedings ought
to be taken. /
To medical men made a special examination of the
* Commissioners’ 25th Report, 1871.
+ 8 and 9 Vict. c, 100, ss, 112, 113,
M
Action for
taking care
of a person
of unsound
mind with-
out the legal
documents.
Judgment of.
Baron Mar-
tin.
Remarks by
Commis-
sioners on
the verdict.
162 MANUAL OF LUNACY
patient, and in their evidence before Baron Martin both
described the case as one of chronic dementia of some
months’ duration.
The case was proved both by the witnesses for the
defence and prosecution.
The defendant having withdrawn his plea of Not.
Guilty, said “the Act had no.doubt been infringed,’’
and threw himself on the mercy of the Court.
Baron Martin, addressing the defendant, said that:
he had no doubt that the patient was a lunatic, but
there was no evidence to show’ that Mr. L. was not:
well treated by him or his servants, and that it would,
in his opinion, be carrying the law to an extreme length
if he were punished.
The defendant was fined 201, to appear and receive
judgment if called upon.
The Judge said that this lenient verdict was given
in consequence of the defendant having taken charge of
the patient “openly and publicly and by consent of the
clergyman, and having treated him as one of his own
family,” adding that “he saw no reason to suppose the
defendant knew anything about the Act of Parliament.”
The Commissioners conclude the description of the
case as follows :—
“The result of this trial was not anticipated by us,
and was, in our judgment, much to be regretted; we
thought it calculated to exercise a prejudicial effect by
encouraging not only the idea that ignorance of the law
is sufficient excuse for its violation, but that unless ill-
treatment be proved the law may be violated with im-
punity. It was not without full consideration that we
instituted these proceedings, and we remain strongly of
opinion, on which we shall always act, that ill-treatment
not being a necessary element in a case of prosecution
for reception of an insane patient without a statutory
order and certificate, the absence of proof of ill-treatment
LIABILITIES OF THE PERSON SIGNING “ oRDER” 163
forms no ground for exempting the offender from punish-
ment,”
Liabilities of Persons who sign the “ Order for Admission.”
In an action brought by a patient against the
proprietor, superintendent, or other “persons in his
employ concerned in the removal of a patient to an
asylum, the order and medical certificates may be pleaded
as a justification for so acting, and the action cannot be
proceeded with, but the person who signs the order is
not included in this section, or the medical men who
have signed the certificates. It occasionally happens
that the person who signs the order is threatened by
the patient after his discharge with an action for, as he
supposes, illegal confinement in an asylum.*
The action cannot be stayed, and the person signing
the order remains subject to liabilities at common law.
In an action + brought by the plaintiff, Miss Nottidge,
against her brother and brother-in-law to recover com-
pensation for the incarceration of herself in a lunatic
asylum, under the pretence that she was of unsound
mind, the defendants, in answer to the charge, put the
following pleas upon the record :—
1st. Not guilty.
Qnd. That the plaintiff was of unsound mind, and
that it was unsafe for herself and for others that she
should be at large.
The plaintiff was placed in an asylum in November
1846, and detained there till January 1848.
She was at this time in possession of property to the
amount of 6,000/.
In 1846-the plaintiff was living with her mother in
Suffolk. In the autumn of that year she went on a visit
* 8 and 9 Vict. c. 100, 8. 99.
+ Nottidge v. Ripley, 1849.
u2
The order,
statement,
and med ‘cal
certificates
will be
sufficient
authority
for the re-
ception of a
patient.
The persons.
who sign
the order
and medical
certificates
are not so
protected.
Action
brought
against the
person who
signed the
order.
Verdict.
164 MANUAL OF LUNACY
to her three married sisters, who resided at Weymouth,
She eventually travelled with them to Somersetshire.
Her sisters’ husbands had adopted peculiar views and
notions with regard to their religious services.
Miss Nottidge, together with two married sisters,
joined a religious establishment called the ‘‘ Agape-
mone,’ or “ Abode of Love.’
' The plaintiff was living in lodgings with one of the
members of the community when the offence complained
of was committed.
The plaintiff’s brother-in-law, Mr. Ripley, in Novem-
ber 1848, went with two gentlemen to the cottage
in which the plaintiff resided, and having entered the
house by a back door, went into the room where she was,
and, laying hold of her, forcibly removed her, notwith-
standing her screams and struggles, into a carriage, with-
out bonnet, shawl, or even shoes to her feet. She was
brought up to London, and two medical certificates ob-
tained, and she. was placed in an asylum, where she was
detained for seventeen months, when she managed to
inform her friends of the place of her confinement. An
application was immediately made to the Commissioners
in Lunacy, who, having investigated the case, ordered
the discharge of the plaintiff from the asylum.
The Lord Chief Baron directed a verdict of “Not
Guilty ” to be returned by the jury, in consequence of
there not being sufficient evidence to prove that the de-
fendants had been guilty of some of the acts entered
against them. With regard to the plea of justification
on the part of the defendants, that the plaintiff was “a
person of unsound mind, and incapable of taking care of
herself,” the Lord Chief Baron said that if the jury were
of opinion that the plaintiff was not in a condition dan-
gerous to herself or to others, the verdiet ought then
to be for the plaintiff. :
The verdict was given for the plaintiff, damages 401.,
LIABILITIES OF MEDICAL MEN 165
the jury adding to their verdict that in their opinion the
defendants were not actuated by any unworthy motive.
In consequence of the opinion expressed during the
trial by the Lord Chief Baron, that no person should be
confined unless he could be proved to be dangerous to
himself or to others, the Commissioners in Lunacy were
induced to send a letter to the Lord Chancellor, in
which they stated that the opinion as expressed by the
Lord Chief Baron was not what was intended by the
LInunacy Acts.
The Commissioners said, “ The object of these Acts is
not, as your Lordship is aware, so much to confine
lunatics as to restore to a healthy state of mind such of
them as are curable, and to afford comfort and protection
to the rest. Moreover, the difficulty of ascertaining
whether one who is insane be dangerous or not is ex-
ceedingly great, and in some cases can only be deter-
mined after minute observation for a considerable time.
It is of vital importance that no mistake or misconcep-
tion should exist, and that every medical man who may
be applied to for advice on the subject of lunacy, and
every relative and friend of any lunatic, as well as every
magistrate and parish officer (each of whom may be
called upon to actin cases of this sort), should know and
be well assured that, according to law, any person of
mnsound mind, whether he be pronounced dangerous
or not, may legally and properly be placed in a county
asylum, lunatic hospital, or licensed house, on the autho-
rity of the preliminary order and certificates prescribed
by the Acts.”
Liabilities of Medical Men who sign the Certificates.
By the Lunacy Act,* “any physician, surgeon, or
apothecary who shall sign any certificate, or do any other
act (not declared to be a misdemeanour) contrary to
*'16 and 17 Vict. c. 97, 8. 122.
Remarks
made by
Commission-
ers on the
judgment
166 MANUAL OF LUNACY
any of the provisions herein contained, shall for every
such offence forfeit any sum not exceeding 201., and any
physician, surgeon, or apothecary who shall falsely state
or certify anything in any certificate, under the Act, in
which he shall be described as a physician, surgeon, or
apothecary, not being a physician, surgeon, or apothe-
cary respectively within the meaning of this Act, shall
be guilty of a misdemeanour.”’
Mistates The following may be mentioned as some of the chief
medical mistakes made by medical men which might lead to a
signing a -_ prosecution :—
which vould Ist. Stating facts not observed on the day of examin-
action for ing the patient. Thus, if a patient is examined on Decem-
meanour, ber the dth, the facts only observed on that day must be
stated, notwithstanding strong symptoms of insanity
were observed on the 4th. :
2nd. Examining the patient in the presence of
another medical man is illegal.
drd. Facts of insanity falsely stated.
4th. Facts falsely stated in the first part of the medi-
cal certificate—for example, a medical man stating that
he is a physician, surgeon, or apothecary, or a registered
practitioner, such not being the case.
Discharge of a Patient by the Commissioners in consequence
of an Illegality in one of the Medical Certificates and
Order. —
Discharge of A patient was admitted into an asylum on July 81,
Contient PY 1862, and on August 2, before any return had been
pore." made to the Commissioners’ Office, the asylum in which
ies’, the patient was confined was visited by two members
of the Board, and on their examining the original cer-
tificates upon which the patient was admitted, they
saw one of the certificates, dated July 29, was founded
on a visit made by the medical man on June 13, six
LIABILITIES OF MEDICAL MEN 167
weeks previous to the admission, thus rendering the cer-
tificate illegal and invalid. The patient was immediately
ordered to be discharged.
The certificate being invalid the ee had. conse-
quently heen illegally detained.
The Commissioners considered the propriety of bring-
ing an action against the medical man who had signed
this certificate. He pleaded ignorance of the law re-
specting the dates of signing the certificate and the
examination of the patient. He stated that he had in
fact seen the patient several times subsequently to his
examination, and once within three or four days before
signing the certificate. The medical man was informed
by the Commissioners in Lunacy that although he had
been guilty of neglect.in not making himself conversant
with what was required by law, nevertheless, as it did
not appear to them that he had wilfully acted in violat-
ing the law, no further proceedings would be taken
against him.
The proprietor of the asylum pleaded inadvertency
in omitting to observe the date of the examination of
the patient.
The Commissioners in Lunacy addressed a letter to
him, the following being an extract :—
“We are instructed by the Commissioners to say
that, having fully considered your explanation, they
cannot think it satisfactory. In their opinion there is
no part of the duty of a proprietor of a licensed house
which requires greater care than the examination of
certificates.
Your long experience ought to have rendered you
familiar with the particulars, in regard to them which
demand special attention. The Commissioners therefore
consider your negligence on this occasion as a grave
offence. They instruct us, however, to say that although
Latter ad-
dressed to
the proprie- .
tor who had
received the
patient.
’
Action for
falsification
of facts in
signing a
medical
certificate
Pleas urged
in defence.
168 MANUAL OF LUNACY:
they will at present forego any further proceedings, yeb.
in the event of a similar occurrence they will without
fail institute a prosecution against you.”
Signing a Certificate of Lunacy without being a duly
registered Medical Practitioner.
A case occurred last year in which the defendant was
indicted under 16 and 17 Vict. c. 96, s. 18, for illegally
signing a certificate of lunacy.
The patient was undoubtedly of unsound mind, and
one medical certificate having been signed by a duly
registered practitioner, the defendant was called in to
sign the second certificate, as required by the Act.
The defendant having filled up the certificate, signed
“ Alexander Ogilvie, R.N.,” and the patient was forth-
with removed to an asylum. The Commissioners in
Lunacy haying received copies of the certificates, in
due course of: time returned them for the signataries to
more fully describe their qualifications. In the amended
certificate Ogilvie described himself as being an M.D.,
St. Andrew’s, but it was ascertained subsequently upon
enquiry at the Admiralty that he was not registered undex
the Medical Act, nor connected with the medical depart-
ment in the Navy, and that he did not possess the degree
of M.D. from the University of St. Andrew’s. ,
The pleas set up in defence were, that he had been
in practice for forty-two years; that he had signed the
certificate at the urgent request of the patient’s relatives ;
that he had testimonials of the highest character from
surgeons and persons whom he had attended; that he had
assisted his father and uncle, who had been surgeons in
extensive practice, and that the act for which he was in-
dicted had resulted in no pecuniary compensation to him.
Mr. Justice Lush observed that this was the first case
in which the Court had been called upon to inflict pun-
ishment for a breach of the section of the Act referred
LIABILITIES OF MEDICAL MEN 169
to by the learned counsel for the prosecution. He had
now, for the first time, to determine what was the proper
punishment for such a violation of the Act as had been
proved before him. The statute gave him no means of
measuring the punishment, but merely classified the
offence as one which might be dealt with by fine or
imprisonment, or both. In short, there was nothing to
guide him in the Act, or no precedent such as was fur-
nished by former decisions. He had, therefore, to
consider the mischief which the Act was intended to pre-
vent; and, looking at the circumstances of this case,
he did not doubt that the defendant’s intentions were
free from moral blame, and that he neither signed the
certificate for any bad purpose of his own, nor with
the intention of lending himself to any bad motives on
the part of other people. The Act under which the
defendant was indicted was intended for the good treat-
ment of unhappy persons deprived of their mental
powers, andas a bar to the machinations of evil-minded
people, and, with that view, it required that, before any
subject was deprived of his liberty, and shut up’ in a
lunatic asylum, a request to that effect should come from
a relative, and be accompanied by certificates from two
medical men. He thought that, under all the circum-
stances, the justice of the case would be met by the
imposition of a fine of 501., and he should direct that
the defendant be kept in custody until the fine was paid.
Statement
in Schedule
C of 20 and
21 Vict. c.
71. Person
who signs
must state
his relation-
ship to the
patient,
170
MANUAL OF LUNACY
CHAPTER XI.
EPITOME OF SCOTCH LUNACY LAW, AND CONDITION OF
LUNACY IN SCOTLAND.
In order to place a patient in an asylum in Scotland a
petition, accompanied by a statement and two medical
certificates, has to be presented to the Sheriff.
FORM OF STATEMENT TO BE LODGED WITH A PETITION
TO THE SHERIFF FOR THE RECEPTION OF A LU-
NATIC.* ,
1.
2.
MOD ON AAP
nd
12,
138.
14.
16.
16.
17.
chargeable.
Christian Name and Surname of Patient at Length.
Sex and Age.
Married, single, or widowed.
. Condition of Life, and previous Occupation (if any).
. Religious Persuasion so far as known.
. Previous Place of Abode.
. Place where found and examined.
. Length of Time insane.
. Whether first Attack,
. Age (if known) on first Attack.
: When and where previously under Examination, and Treat-
ment,
Duration of existing Attack.
Supposed. Cause.
Whether subject to Epilepsy.
Whether suicidal.
‘Whether dangerous to others.
Parish or Union to which the Lunatic [if a Pauper] is
'
* The person who presents this statement to the sheriff must
state the degree of relationship or other capacity in which he stands
to such lunatic,
LUNACY IN SCOTLAND val
18, Christian Name and Surname and Place of Abode of nearest
known Relative of the Patient, and Degree of Relationship (é
known), and whether any Member of his Family known to be or to
have been insane.
19. Special Circumstances (if any) preventing the Insertion of
any of the above Particulars.
I certify, That to the best of my Knowledge the above Particu-
lars are correctly stated,
Dated this day of One thousand
eight hundred and
[To be signed by the Party applying.)
FORM OF MEDICAL CERTIFICATE. Medical
* T, the undersigned, [set forth the Qualification entitling the person Schedule D,
certifying to grant the Certificate, e.g., being a Member of the Royal a Be
College of Physicians in Edinburgh,] and being in actual Practice :
as a [Physician, Surgeon, or otherwise, as the case may be], do
hereby certify on Soul and Conscience, That I have this Day at
[insert the Street and Number of the House (if any), or other like
Particulars,] in the County of , separately from any
other Medical Practitioner visited and personally examined A.B.
[tsert Designation and Residence, and if a Pauper state so], and
that the said A.B. is a Lunatic [or an Insane Person, or an Idiot, or
-a Person of unsound Mind], and a proper person to be detained
under Care and Treatment, and that I have formed this Opinion
upon the following Grounds, viz. :—
1. Facts indicating Insanity observed by myself [state the
Facts). 7
2. Other Facts (if any) indicating Insanity communicated to
me by others [state the In, formation, and from whom].
(Signed) [Name and Medical Designation and Place
of Abode.|
Dated this day of One thousand
eight hundred and
5 : .: Persons
The medical men who sign these certificates must tie ae
have no immediate or pecuniary interest in the asylum to sign the
in which the lunatic is to be placed; but one of them :
may be the medical superintendent, consulting or as-
* The law fixes no limit to the duration of the validity of the
medical certificate.
Schedule ,
20 and 21
Vict. c. 7]
Sheriff's
order.
Twenty-one
days allowed
for the
alteration
of defective
certificates.
172 MANUAL OF LUNACY
sistant physician of such asylum, provided it is not a
private asylum.
If the Sheriff is satisfied, he will grant an order for
the reception of the lunatic into the asylum...
FORM OF ORDER TO BE GRANTED BY THE SHERIFF
FOR THE RECEPTION OF A LUNATIC.
I, G.H., Sheriff [or Sheriff Substitute, or Steward, or Steward
Substitute] of the County [or Stewartry] of , having
had produced to me, with a Petition at the Instance of ZK. pe
and Designation], Certificates under the Hands of
and , being Two Medical Persons duly qualified in
Terms of an Act Lepecify this Act], setting forth that they had
separately visited and examined A.B. [describe him, and if a Pauper
state so], and that the said 4.B. is a Lunatic, [or an insane Person,
or an Idiot, or a Person of unsound Mind,] and a proper Person to
be detained and taken care of, do hereby authorise you to receive
the said 4.B. as a Patient into the Public [or Private] Asylum of
, and I authorise his Transmission to the said
Asylum accordingly, and I transmit to you herewith the said Medical
certificates and a statement regarding the said 4.B. which accom-
panied the said Petition.
Dated this day of ‘ 18
(Signed) GH.
To the Superintendent of the Public [Designation.]
(or Private) Asylum.
This order, signed by the Sheriff, must be dated
within fourteen days prior to the reception of the luna-
tic, and no superintendent can detain a lunatic without
such being the case. If the order is signed by the
Sheriff of Orkney and Shetland, there must be an in-
terval of twenty-one days between the date of the order
of the Sheriff and the-reception of the patient. But if
one medical man certifies that the case is one of emer-
gency, then the superintendent shall be justified in re-
ceiving and detaining the patient for a period not
exceeding three days. Twenty-one days are allowed for ..
altering defective certificates ; but no such amendment
LUNACY IN SCOTLAND 173
shall have any force without first receiving the sanction
of the Board. ,
A copy of the order, medical certificates, petition,
and statement must be sent to the Commissioners after
the expiration of two clear days, and before the expi-
ration of fourteen clear days, from the reception of the
patient.
A notice of the patient’s admission must also be
sent to the Board with these documents, and also a
report signed by the medical attendant of the asylum
into which the patient has been received.
NOTICE OF ADMISSION.
I hereby give Notice, that.4.B. [describe him] was received into
this House as a Private [or Pauper] Patient, on the ‘
day of : , and I hereby transmit a Copy of the Order
and Medical Certificates and Statement on which he was received,
Subjoined is a Report with respect to the mental and bodily
condition of the above-named Patient.
(Signed) Z.F., Superintendent.
Dated at this day of One
thousand eight hundred and :
REPORT.
T have this day seen and personally examined 4.B., the Patient
named in the above Notice, and hereby report and certify, with
respect to his mental state, that [insert Particulars], abd with
respect to his bodily Health and Condition, that [insert Particulars].
(Signed) L.M., Physician [or Surgeon].
Dated this day of One thousand
eight hundred and
The Sheriff’s clerk must, within seven days after the
granting of the order, send a notice to the Board, stating
who made the application, and to whom the order applied ;
also the names of the medical men who signed the certi-
ficates and the Sheriff who granted the order; and also
the name of the asylum or house to which the order was
addressed.
Documents
to be sent to
Commission-
ers within
fourteen
days from
the ad-
mission
Schedule F,
20 and 21
Vict. ¢. 71.
Sheriff’s
clerk must
send notice
to the Board,
containing
particulars
relative to
the patient’s
admission.
Any person
signing a
false certifi-
cate is liable
to imprison-
ment or fine.
All asylums
must be duly
licensed.
No person
can be de-
tained in an
asylum
without the
proper
documents,
Asylums
licensed for
one hundred
patients
must have a
resident
medical
superin—-
tendent.
If licensed
for more
than fifty,
and less than
one hundred
patients, it
must be
visited by
a medical
man daily.
174 MANUAL OF LUNACY
Any Sheriff’s clerk who fails to comply with such
notice shall for every such neglect forfeit a sum not
exceeding 100.
Any person who wilfully and falsely grants a certificate
to the effect that a person is a lunatic, the grantor of such
certificate, according to the Act, is guilty of an offence, and
liable for each offence to a fine not exceeding 3001., or to
imprisonment for any period not exceeding twelvemonths.
The patient must be seen and carefully examined by
the medical man who signs the certificate. If this is
not complied with, the person signing is liable to a.
penalty not exceeding 501. :
All private houses and asylums must be licensed ; and
any person receiving lunatics into his house without first.
obtaining a licence is liable to a penalty not exceeding
100/., or to imprisonment for any space not exceeding
twelve months.
This not only applies to the keeper of the asylum,
but also to the person who sends the patient to the
asylum or house, if he is aware that the same is not.
licensed.
Any person detaining or harbouring any lunatic in
any asylum, whether public or private, or in any
house, without proper order and certificates, is liable
to a like penalty. This applies also to the person who
sends the lunatic into the asylum or house without the
legal order and certificates.
Resident Medical Officers.
All asylums licensed for one hundred patients, or
more than this number, must have a medical man re-
siding on the premises, as medical attendant thereof.
All asylums licensed for more than fifty and less
than a hundred patients, having no medical man re-
siding on the premises, must be daily visited by a
medical man.
All asylums licensed for fifty or less than fifty
LUNACY IN SCOTLAND 175
patients, and having no resident medical man on the
premises, must be visited at least twice in every week
by a medical man.
The Board have power to diminish or increase the
number of visits, if they think proper; and if they see
sufficient cause, they may require a resident medical
man to be appointed to any asylum licensed for more
than fifty patients.
All asylums licensed for less than eleven patients
may be visited by a medical man less frequently than
twice in every week.
This entirely rests with the Board, who give their
written authority for these visits.
Discharge of Patients. :
A relative or friend of the patient is legally em-
powered to authorise his discharge from an asylum,
having previously procured the certificates of two
medical men approved of by the Sheriff. The person
who placed the patient in the asylum requires no such
order. These certificates must be to the effect that the
patient has recovered, or can be liberated without risk to
himself or to the public. An order from the Sheriff for
the discharge is also obtained ; and this, together with the
two medical certificates, will require the superintendent
to discharge the patient.
The Board also have power, on being satisfied with
the certificates of two medical men whom they may
consult as to the recovery of a patient, to order his
liberation.
It is necessary, previous to the liberation of any such
lunatic by order of the Board or Sheriff, to give eight
days’ notice in writing of such intended liberation to
the person at whose request such lunatic was confined ;
or, in his absence, to the nearest relative of such
patient.
Asylums
licensed for
less than
fifty patients
arerequired
to be visited
twice during
the week.
If licensed
for less than
eleven
patients, the
visits can be
made less
frequently
than twice:
during the
week.
Relative or
friend can
authorise
the patient’s
discharge. ;
The Board
have power
to discharge
the patient.
Notice re-
quired
previous to
discharge of
a patient.
The super-
intendent
must enter
into a
register the
particulars
relating to a
patient’s
removal.
Register of
lunatics
required to
be kept in
all asylums.
176 MANUAL OF LUNACY
In the case of a pauper lunatic notice must be given
to the person or parish at whose expense his maintenance
was defrayed.
The superintendent of an asylum, upon the removal
or liberation of any patient, is required to enter, or cause
to be entered, into a register to be kept by such superin-
tendent the particulars of the removal of such patient,
the date thereof, the authority on which such removal
“was made; and, in the case of a lunatic discharged as
incurable, the facts of such discharge must be stated in
the register of the asylum, also a specification of the
place where the patient has gone, and the person under
whose care such lunatic has been sent. -A copy of these
entries must be transmitted to the Board by the superin-
tendent within twoclear days from the date of the patient’s
removal.
Register of Lunatics to be kept in Asylums.
In all public, private, and district asylums there
must be kept a register; a copy of this must be trans-
mitted to the Board as they shall direct; and all super-
intendents failing to comply with this are liable to a fine
not exceeding 201.
REGISTER OF LUNATICS.
LUNACY IN SCOTLAND
177
suor}Barosqg |
ET
PoAOIdUIT 4O Nc
pesol[ey
pesreyqosiq
A S|
pareaccey
qyeoq 10
‘Tesourey ‘asreqosiq Jo ay8q
1850.
1852.
1857.
MOvyV 9s1g 0 os Vy
-} 3}Dec. 2) -| -| -| -| -
SYOVITV snotaerd jo Jaqunyy
syory S390M
le
“TV Suystxe sq}UOyL
jo woNnving Sx8aX.
SJOIDT yeyIUesu0p
sondendg
-| -) -| +! -/5
-|-|-| - 1) -} -} 4/June8) -| -) -
Ayraesay jo esnvo pesoddng
‘(Aue JI) Japrosiqg Jo eure Ny
worpuco Sppog
-| -[Melancholia] -| -| -| -; 4| -| -[17/Sept.1] 1} -| -] -! -
peusts moym Aq pus
‘saqvogideD Teorpeyy JO sexed.
ques Aq110q4ne osoya. Ag
arqeesireyo
feo 04 Ystteg 10 Lyan0D
apoqy JO ev[q snolaetg
toryedno09 sno
-Taord pur ayy] JO UOIpUCH
PaMOpLM,
a[sulg,
pere
as to
Mar-’
riage
Condi-
asy
Sex
and
Pri- |Pau-
Class
vate] per
MF|M|F.
-|-{1]-|25) -] 1) -
-|-|1|-|29] -| a} -
and
Surname
al
Christi
t
full length
om
°
Date
sion
”
Admis- |
1850.
1852.
1856.
mors
any, Jo sepaio ur zaquinyt
1 | Jan. 3 |William Turner |-|-| 1) -|23} - 1 -| Carpenter! -|
4 | June 9 |Henry North
7 | May 6 |William Smith
(fue JI) ors
-srmpy stioqsaad qsvy Jo aye |
Proceedings
necessary on
the death of
a patient.
Schedule J,
20 and 21
Vict. ¢. 71,
Boarders
can be re-
ceived into
asylums, -
having
previously
178 MANUAL OF LUNACY
Death of. Patients.
In the event of the death of a patient confined ina
public, private, district asylum, or private house, a state-
ment must be prepared and signed by the medical man
who attended the lunatic during his last illness or at
the time of death. This statement, containing the fol-
lowing particulars—the time and cause of the death, and
the duration of the disease from which the patient died—
must be sent by the superintendent of the asylum within
three days from the death to the Board, also to the per-
son or parish by whom the expense of the lunatic’s main-
tenance is defrayed, and to the person on whoseapplication
the lunatic was confined ; and any medical man or super-
intendent failing to transmit this is liable to a penalty not
exceeding 50].
A “register of deaths ’’ similar to the one given must
be kept at all asylums.
REGISTER OF DEATHS.
g q
A
F @ | Christian and 4
o
q Q Sex and Class 9
3 » |A Surname a Age 4
s | 4 [3 S | a | §
_ | & | at ful Lengin [Private|Pauper| | Death 2
a aA |e MI/F.)M/F.| qo [M/F] oO
1850: | 1850:
Sept. 1} Jan. 2 | — |William Johnson|— |— | I |— - 23) —
1852 ; | 1852:
Dec. 2) June9} — |John Brown | 1 |— | —|— - 25 | —
1856 : | 1855:
June 8} May 6| — |William Smith .|—}— | 1 |—|Phthisis| 27] —
Boarders im Asylums.
It is lawful for the superintendent of any asylum to
receive as a boarder in an asylum any person who is de-
sirous of submitting himself to treatment, having pre-
LUNACY IN SCOTLAND 179
viously obtained the consent, in writing, of one of the
Commissioners.
The boarder must make written' application to the
Commissioners to be admitted, and the mental condition
of the boarder must not be such as to render it legal for
certificates of insanity to be granted.
The Commissioners in Lunacy at the time of their
visit must examine every boarder.
Boarders have power to leave the asylum after hay-
ing given three days’ notice, unless medical certificates,
together with an order from the Sheriff, have been pro-
cured ; but in this case neither of these certificates shall
be signed by any medical man connected with the asy-
lum, or who has any immediate or pecuniary interest in
it. In the event of a boarder being received into an
asylum, or on the discharge or death of any such, notice
moust be forwarded to the Commissioners as in the case
of a patient confined under certificate.
Single Patients in Private Houses.
No person can receive a lunatic into his house for
profit without an order from the Sheriff, or the sanction
of the Board. Any person receiving a lunatic into his
house must, within fourteen clear days from the date of
his reception, make an application for such order or
sanction.
If the lunatic is a pauper, the application must then
be made by the inspector of the poor,’and in such a case it
is lawful for the Sheriff to grant his order on one medical
certificate.
All patients confined in private houses are visited by
a medical man as often as the Board shall regulate, and
he must enter in a book kept in the house the date of
each visit, the mental and bodily health of the lunatics
at the time of the visit; “and every medical man who
shall make an entry without visiting the patient within
° n 2
obtained the
‘ consent,of
a Commis-
sioner,
A boarder
can leave
the asylum
on three
days’ notice.
Notice for-
warded to
the Com- *
missioners
on the dis-
charge or
death of a
boarder.
It is illegal
for a patient
to be de-
tained in a
house as a
single
patient
without the
legal docu-
ments.
Regulations
affecting
single
patients.
The Board
can autho-
rise the
transfer of
any single
patient.
No person
can detain
in his house
an insane
relative
beyond a
year without
permission
from the
Sheriff or
Board.
Section re-
ferring to
the deten-
180 MANUAL OF LUNACY
seven days of making such entry, or who shall wilfully
make any false. entry in the book, is liable to a penalty
not exceeding 201.”
The Board are empowered to order inspection and
visitation ‘of every private house, from time to time, as
they may think proper.
Any person detaining, or aiding in detaining, any-
one who upon enquiry is found to be of unsound mind,
without an order or sanction of the Board, is liable to a
penalty not exceeding 201.
This does not only to patients as have been sent
under certificate of a medical man on temporary leave of
absence for a period not exceeding six months.
The Board, if they think proper, in consequence of
ill-treatment or otherwise, may order the transfer of a
patient to any other private house, or to any public,
private, or district asylum, as they may deem expedient.
The expense of the maintenance is chargeable on the
property of the lunatic, if he possesses any, or on the
person or parish legally bound for his maintenance.
Single Patients residing in Private Houses without Profit
to the Occupier.
No proprietor or inmate of any private house can
receive or detain therein a lunatic, although not for
profit, notwithstanding the patient is one of the family
and a relative of the inmate or proprietor, beyond the
period of a year, the malady being such as to require
seclusion, restraint, or coercion of any kind, without an
order from the Sheriff or the sanction of the Board.
The proprietor or occupier must give the particulars
of the case to the Board, stating the reasons which ren-
der it desirable that the patient should remain under
private care. “Ifthe Board have reason to believe that
any person of unsound mind, and whose case has been
thus intimated to them, or of whose case no such intima~
LUNACY IN SCOTLAND 181
tion has been made, has been subjected to compulsory
confinement in the house, or to restraint or coercion of
any kind at -any period beyond a, year from the com-
mencement of the insanity, or has been ill-treated, the
Board, or one or more of its members, have power, hay-
ing previously obtained the consent of one of Her
Majesty’s principal Secretaries of State, or Her Majesty’s
Advocate for Scotland, to visit and inspect such lunatic,
and to make such enquiry concerning the treatment as
such member or members shall deem fit; and if it appears
that the patient has been detained for a space exceeding
-@ year, and that seclusion, restraint, or coercion has
been resorted to, or that the patient has been ill-treated,
and that the circumstances are such as to render the
removal of such patient to an asylum desirable, then it
shall be lawful for the Board to make application to the
Sheriff for transfer of such patient to any asylum or
house.”
Correspondence of Putients.
All letters written by patients in any asylum or house
and.addressed to the Board, or Secretary of the Com-
missioners, or to any one of them, must be forwarded
unopened, and all letters from the Commissioners ad-
dressed to such patients, and marked “ private,” must be
delivered to the patient unopened, and any person who
shall intercept, detain, or open any such letters without
the authority of the patient concerned, shall be liable to
a penalty not exceeding 101.
The Board have power to send a copy of such letter
to the superintendent of the asylum if it appears neces-
sary to acquaint him with its contents.
COMMISSIONERS IN LUNACY.
Chairman.—Sir Joun Don Waucuore, Bart.
Commissioners.—The Rt. Hon. Gzorcz Youne, M.P., Lord
Advocate for Scotland ; Gzorcz Monn, Esq,, Sheriff of Linlithgow-
shire; Sir James Coxz, M.D.; Arruur Mircuerz, Esg., M.D.
tion of
insane
relatives.
Letters
written by
patients in
asylums.
182 MANDAL OF LUNACY
Deputy Commissioners—G. A. Parzrsoy, Esq, MD.; J.
Srpparp, Esq., M.D.
Secretary.—WiL11aM Fores, Esq.
Clerk to the Board.—W. J. Barr, Esq.
Clerks. —T. W. L. Spence, W. Denton, and J. Witson, Esgs.
Messenger.—W. Lzar.
Office: Post Office Buildings, Edinburgh.
The number and distribution of the insane in Scot-
land on January 1, 1871, exclusive of unreported lunatics
maintained in private dwellings from private sources,
were as follows :—
Private Pauper
Dison con Male| Female |Total|Male| Female|Total|M ale Female |Total|
In _Royal and
District Asy-
lums . » [2,248] 2,281 4,524) 488) 464 952] 1,755) (1,817 |3,572|
» Private do. .| 180) 208 338] 103) 158 261| 27 50 17
y» Parochialdo. | 214) 330 6444 —} —
» Lunatic
Wards of
Poorhouses 263) 367 630} — _ —| 263} 367] 630)
»» Central Pri-
‘son. 35 16 51) — | — —| 35 16 51
» Training
Schools for
Imbeciles .| 81 42 123) 61 30 91) 20) 12 32)
», Private Dwell-
ings . -| 670) 849 {1,513] 22 34 56] 648} 815 11,46:
—| 214) 330] 544
Totals . | 3,636) 4,093 | 7,729) 674) 686 |1,360)2,962] 3,407 | 6,369
7
Besides the number of insane given above, it is
estimated that there were about 2,000 persons of unsound
mind unreported, making the total number 9,729, the
ratio per thousand of insane persons to the population
being rather more than two.
Number of insane in Asylums
Jan.1,1871 . . . 5,406
Admitted during the year . 1,836 (excluding transfers)
Recovered . . 7 - 810
Died . A . : . 539
LUNACY IN SCOTLAND
183
The following table shows the distribution of the in-
sane on January 1, 1858, and on January 1 from 1862
to 1871. This muabel does not include the inmates of
idiot schools, who are not certified as lunatics :—
1858
houses
Prison
In Royal.and
District
Asylums .| 2,380)
In ' Private
‘Asylums .| 745
In Parochial
Asylums
and Luna-
tic Wards
of Poor-
In Lunatic
department,
of Central
In_ Private
Dwellings | 1,804
Total . | 5,794)
«| 839
. 26
1862
2,820)
921
838)
29)
1,762
1863
2,822
927
878
30
1,700
1864
1865 | 1866 | 1867
1868
1869 | 1870 | 1871
2,919
872
910
32
1,658
8,125} 3,2
788) 812) . 672
925] 1,0
36
1,630] 1,5
46] 45
89]1,573
07| 8,519
08} 998
3,874
501
1,007
1,549
4,041] 4,461) 4,524
557
303] 338
1,024]1,127/1,174
* 50
49} 51
1,535] 1,518] 1,519
6,370
6,357
6,391
6,504) 6,662] 6,807
6,976
+
7,207| 7,458} 7,606
~ From the following table it is seen that on an ave-
xage of the ten years from 1862 to 1871, out of every
100 patients sent to asylums 25-8 were private and
742 pauper. ‘
Numbers placed in Establishments, excluding Transfers
Private Pauper General Total
Years :
Male |Female| Total Male Female] Total | Male |Female| Total
1862 192 192 | 384) 449 541 990 } 641 733 | 1,374
1863 173 207 380 | 472 536 | 1,008 645 743 | 1,388
-1864 181 169 | 350} 513 558 | 1,071 | 694 727 | 1,421
1865 198 221 419 | 484 559 | 1,043 682 780 | 1,462
1866 235 210 | 445 |) 538 585 | 1,123 | 773 795 | 1,568
1867 210 235 | 445 | 597 663 | 1,260 | 807 898 | 1,705
1868 182 215 | 397 | 628 691 | 1,319 | 810 906 | 1,716
1869 219 218 | 437 666 800 | 1,466 | 885 | 1,018 | 1,903
1870 208 223 | 431 607 750 | 1,857 | 815 973 | 1,788
1871 227 254 | 481 647 708 | 1,355 874 962 | 1,834
Average |oq9-5 | 214-4 |416-9 |560°1 | 639°1 |1199-2 |762-6 | 853-5 | 616-1
per year
184 MANUAL OF LUNACY
On the other hand, an analysis of the following table
will show that in the same period out of every 100
patients discharged recovered 248 were private and 75:1
pauper ; of those discharged not recovered 43-2 were
private and 56:8 pauper; and of those who died, 17:9
were private and 82°1 pauper.
The ratio of recoveries among private and pauper
patients is very nearly according to the ratio of admis-
sions. A large proportion of the private patients are
discharged not recovered, and as a consequence the
mortality of the private patients is in-a lower ratio when
compared with the admissions than that of paupers.
Removed re- | Removed not
covered recovered Deaths Total Removals
Years
Private|Pauper|Private|Pauper |Private| Pauper] Private Pauper| Total |
1862 137 439 148 144 76 362 361 945 | 1,306
1863 161 | 452 123 205 82 301 366 958 | 1,324
1864 155 429 101 | 172 63 335 319 936 | 1,255
1865 166 462 1387 | 114 |° 64 299 367 875 | 1,242
1866 191 482 106 159 91 342 388 983 | 1,371
1867 191 513 128 134 84 419 403 | 1,066 | 1,469
1868 169 584 127} 142 | 103 349 399 | 1,075 | 1,474 |.
~ 1869 197 596 124 194 76 453 |° 396 | 1,243 | 1,639
1870 196 646 117 173 92 449 405 | 1,268 | 1,673 |
1871 172 638 152 225 91 448 415 | 1,311 | 1,726
Totals | 1,785 | 5,241 | 1,263 | 1,662 | 821 | 3,757 | 3,819 |10,660 |14,479
On the next page is given a table showing the causes.
of death in asylums during the year 1871.
185
LUNACY IN SCOTLAND
T ‘ 8 wre a 6./¢ [8 |9 | 8} 8 [21/8 | 8S | Ss |LSPSl| FElOSIPLIG |PLIeFistizT/es|IZ|| °° | ** O-e6TS|O-T98s] * sTeIOL
T° “N18 iP IIT Sig yin] "| Lie IL | & & 19 1h HP (9 [ye TIL a 1S |S [19-06 [0-28 10-998 10-298 sosn0y
“100g JO
Spe.
oryeuwy
GIT S$ EP WT IE le |b) SI] ie lc} % ITT ||P |T ie |'"le [9 IL [iL |G [6-98 /¢-8¢ |l0-eee |e-212 sumnpssy
3 . Lerqooreg
WT HS Ie Ty 7 ay T/& POT “IT |8 IT , E [°'|G |[2-99 10-08 |19-S1% |S-08T * sunt
“ASY OYBAllg
“"Y118 1S |[SSiSSlOTT |S jT 9 |P | 9] 2 lOTl9 | OT | 2% ipelozilozlecis 8 ITTSSiLT|SLET|GL]|8-0F | L-Gh |1¢-982S [0.9623 sunpisy
: qoLnystq.
pus pehoy
{Pela} 7el rh “A A a) “A | aL] “|W ate al alc alata || we | Te “a “hn
car ~3| 2) ezel Blceseel eo leccH ol ele
. Q Olae! os pout’ Q Aen Q| wl] & &
2 Zlo8|] slog Be] g28) SSlesese! § |zegFEe|2| 8 we | Beua
B ZIES lad Be a & Bo g ce beled a EES 3 ae BS aS Bees quaptsey
B a # 4 *
gq 82 |ey ET Bg ae Se g 2 Puke & eye Be a £4 jaa Bans gequng, | SNOTASY
Be |/® F138 g Bs" Eowo| & |/o 8 ZAP | ie Ba
Af GBP Si Rg ies Go) see Lg ehoss| § ag He) 8 eB CERES
a 5/41] BIS & BEgo| 6 Wel sis a BE
2 r E ea ‘Be £| 778) Be] gee re} "el Pla = oeee ose0ay
ee a] OSBIST &e{ StOQ
: Bi 2 eurmopay || ®S¥@sic o1owouz, psvastcr remdg pus peaqarop gee
' “TART t ‘sasnoy.soog fo spivyy oypunry pup ‘suunfisy
oryoow gy pun ‘annua “oygng m pag oyn syuayng fo yywacy fo sesnoy oyg bamoys o1qny,
’
Patient
received on
one certifi-
cate, and
without
ee from
186 MANUAL OF LUNACY
Private Asylums.
There are nine private licensed houses in Scotland.
The subjoined table shows the distribution of the
patients in private asylums on January 1, 1871, and
Jauuary 1, 1872: ‘
.On Jan. 1, | On Jan,1,°
1871 1872 °
Town Name of Asylum
oO Cy
a@\a @lal. -
2/81 8)3| 8 | S| Proprietor
alae lala }|e]ea Sig
Glasgow <|Garngad House .| 16] 9 | 25|13]|.. | 13 | Dr. Hill
Edinburgh | Gilmer House «| 11 | 12 | 23 | 10 21*| Mrs,,Saidleir.
Edinburgh | Halleross House .| 29 | 52 | 81 | 24 | 47 | 71 ee
Bothwell’.|Kirklands . .| 19 | 23 | 42 | 87 | 34 | 71 | Dr. Fairless,
Edinburgh | Melville House .| 12] 8] 20| 7 | 15 | 22 a
Edinburgh | Newbigging House | 2 | 30 | 32} 2 | 30 | 32 | Mrs, Moffat. _
-Edinburgh | Sanghton Hall .| 29 | 36 | 65 | 28 | 38 | 66 { Drs. Smith &
Lowe. 2
Dumbarton | Westermains. .|..] 3] 3] .. | 18 | 18 | J. Laurie, Hq.’
Inveresk .| Whitehouse . .| 12 | 35 | 47 | 12 | 37 | 49 | Mra, ings.
Totals. - {180 }208 |838 |183 |225 |358
¥
Before concluding this chapter it might be as well
to mention that, in a case of emergency, a patient can be
admitted into an asylum on one medical certificate and
without an order from the Sheriff; but he can only be
detained for a period not exceeding three days. After
this period the order from the Sheriff and two medical
certificates must be obtained.
187
LUNACY IN SCOTLAND
GP | SG | SS | 9-12 6 02 19 9F Te 61 Sel | 88 | 9-916 | 9-081 * "syNsay Tere)
"e188 | GaP ie T T a g IL I 0-98 | 0-81 s 8 8 8 esos M *6
oe an o ae o . L o “s aa OL « log . + + © © guypeunteysem “8
LG [OL | S-8L | 00% T & ¥ ¢ & P IT OL | 2-28 | 988 = ‘ * TIeH woyysneg *,
seodott | Rge Pott rr * 19 Pe ‘| ID | tt [008 1} 0% ‘8 8 + BUPsByQMON *9
ve 1 9G9 “* 1 8-88 os ¢ & ¥ ae z 6 9 O-IT | 0-6 ny oy * * STAPH "¢
G8 | SFL | 0-93 | &IT TI ¥ 6 8 L y 8% Pe | 8-83 | 0-86 i so + SPURTE *F
PPL | TSS | S-Fo | 9-86 L 9 61 ar | 8 ¥ && LIL | 9-8% | 0-96 7 ee “BSOIOTISH °S
"* 146 | 0:08 ny re T 9 I T AS g T GIL | 9-0 7 ; é * Tema °S
“* 16:9 | 9-86 | 6:93 7 T 61 ot y g | F 61 {ob | 9-FL sof 8 8 pasar *T
PI EL PIB El El Sl Ele Ele |e) 2 |e
ee (8) SL Ele) Ee |e) by & BL ele |e
@ i ® o oO @ ® ®
aap rarer ee Sioa SHOIASY JO SUNN
do "qua0 rad oe sqq80q. qou Soteaodosy | SMOISSIUIPY | equUUN
- ena 50 woryzodoxg, sasreqosiq. aseloAy
“max ayy buninp sumphsy opomig 07 amgojas sampnorlogy burnb 9790],
188
MANUAL OF LUNACY
District and Chartered Asylums.
Superintending Visiting
County Asylum Physician or Physician or
Surgeon Surgeon’
Aberdeen .| Aberdeen Royal Asy-| Dr.Jamieson. Assts., | Dr. Macrobin
lum, Drs. J. H. Smith and
Yeates.
Argyle .|Argyle and Bute | Dr. James Rutherford 4 -
District Asylum.
Ayr . .| Ayrshire District | Dr. C. Skae a ee .
Asylum,
Banff. . gee District Asy- | Dr. Mausen . «fe . oo.
lum,
Dumfries .}| Crichton Institu- } Dr. Gilchrist. Assts.,| Drs. Borth-
tion, Dumfries;| Drs. Malan and An-|} wick and
Southern Counties} derson. Scott.
Asylum,Dumfries.
Edinburgh.| Edinburgh Royal} Dr.Clouston. Assts.,| . e .
Asylum. Drs. Haigh, Wright,
and Sheaf.
Elgin . me Pauper Asy-| Dr. Ross . a oi] a A .
Fife . -| District Asylum .|Dr.Tuke. Asst.,W.| . . .
F. Morrison.
Forfar . panes Royal Asy-| Dr. Rorie . . «| Dr. Cocks,
um,
” Montrose Royal| Dr. Howden. sst., | Dr. Johnston
: Asylum. - Dr. Balfour.
Haddington | District Asylum .}) Dr. Howden is . . a
Inverness .| District Asylum .| Dr. T. Aitken. Asst., -
Dr. McDowal.
Lanark .j| Glasgow RoyalAsy-| Dr. A. Mackintosh. | Dr. Fleming
lum. Assts.; Drs. Hay and
Blair.
Perth -| Murray’s Royal In- | Dr. Lindsay . el we .
stitution.
” District Asylum .|Dr. C. McIntosh.| . ar oss
Asst., Dr. Wilson.
Roxburgh, | Millholme MHouse,|Dr.Grierson . .| . . +
Berwick, Musselburgh.
& Selkirk.
Stirling .| Stirling” District | Dr. F. Skae Ce a
Asylum,
450
80
250
120
250
,
LUNACY IN SCOTLAND 189
'
Poorhouses Licensed for Pauper Lunatics.
County Poorhouse. Governor
Aberdeen . | St. Nicholas, Aberdeen . . 7 . | W. Dalgleish.
35 Buchan Combination Poorhouse . . | Arthur Ramsay.
a Old Machar ditto . . + | M. McLeod.
Ayr. , .| Cunningham Combination, Irvine’ . | A.M. R. Findlay.
Dumbarton | Dumbarton Combination . . + | J. McLean.
Edinburgh | Edinburgh City . ‘ a . + | Daniel Kemp.
5 South Leith 2 . . . + | J. Cowan.
Forfar «| Dundee . a . . : . «| D. Gunn,
7 LiffangBenvie . . . . «|S, Stewart.
Kincardine | Kincardine -. - . . . | J. Christison.
Lanark . | City Poorhouse, Glasgow * x . | J. Robertson.»
oe Barnhill ditto + « «| J. M. Mackay.
a Govan, Glasgow . < me - | J. McCulloch.
Ys ax Hamilton e + « « «| G. Edwards,
Linlithgow | Poorhouse, Linlithgow + « « «| D.B. Buglass,
. Perth. . | Perth : * s - | J. Reddie.
Renfrew . | Abbey Poorhouse, Paisley a . . | C. W. Laing.
3 6 Burgh ditto, ditto . =: .» «| W. Mackenzie.
: 58 Greenock ditto, Greenock 5 5 . | Archd. Blair.
‘} Wigton .| Wigton . ee fe 86 : . | D. Moreland.
¥Forfar—Baldovan, Dundee
Trainove InstituTiIons For ImpeEcimzs.
» Dr. Greig, Visiting Physician.
Mid Lothian —Columbia Lodge. Dr. Brodie, Physician and Professor
Stirling—Larbert . :
. Dr, Ireland, Physician.
Licences,
Statement
and order.
190 MANUAL OF LUNACY
CHAPTER XII.
EPITOME OF THE IRISH LUNACY LAW AND CONDITION OF
LUNACY IN IRELAND.
It is illegal for any person to receive two, or more than
two lunatics into his house without first obtaining a.
licence from the justices, given on certificates from the
Inspectors.
Fourteen days’ notice of the application for licence
must be given to the clerk of the peace for the county
previous to the meeting of the justices of the quarter
sessions.
The application must contain certain particulars
relating to the number and sex of patients proposed to
be received, description of the house and grounds, name
and previous occupation of the proprietor, and,, if the
proprietor does not intend to reside on the premises,
the application should contain the name of the proposed
resident superintendent.
No person can be received into a licensed house
without an order and two medical certificates.
The order may be signed by a relative or friend of
the patient.
On the next page is given a form of the order which
is required previous to the admission of a patient into
an asylum.
LUNACY IN IRELAND 191
STATEMENT AND ORDER TO BE ANNEXED TO THE
MEDICAL CERTIFICATES AUTHORISING THE RECEP-
TION OF AN INSANE PERSON.
The Patient’s true Christian and Surname at full
length . . . . ‘ : }
The Patient’s Age
Married or Single
The Patient’s previous Oceupation (if saya
The Patient’s previous Place of Abode.
The licensed House, or other Place (if any) in which
the Patient was before confined
Whether found lunatic by Inquisition, and Date of
Commission : :
Special Circumstances which shall prevent the
Patient being separately examined by two
Medical Practitioners : ‘
Special Circumstances which exist to prevent met
Insertion of any of the above Particulars .
Sir,
Upon the Authority of the above Statement, and the annexed
Medical Certificates, I request you will receive the said
as a Patient into your House.
I an, Sir,
Your obedient Servant,
‘Name
Occupation (if mages
Place of Abode .
Degree of Relationship @ ony) to the ie In}
sane Person . :
To Mr.
Proprietor of.
The medical certificates are required to be properly
filled up and signed by two medical men, who must not
be in partnership with each other, and who are required
to separately visit and personally examine the alleged
lunatic within seven clear days previous to the admission.
The certificates must be signed and dated on the day
the patient is examined. If only one certificate can be
obtained, the special circumstances which have prevented
Particulars
relative to
the signing
the medical
certificates.
Documents
to be sent
to the In-
spectors of
Asylums,
192 MANUAL OF LUNACY
the patient from being examined by two medical men
must be clearly stated in the certificate. If a patient
has been admitted upon one medical certificate, it is
necessary for another one to be obtained, signed by a
medical man, within fourteen days from the signing of
the first. The medical certificates cannot be signed
by anyone who is wholly ‘or partly the proprietor or
regular professional attendant of the asylum, or whose
father, son, brother, or partner is wholly or in part pro-
prietor, or the regular professional attendant of such
asylum. I give below a form of the medical certificate.
FORM OF MEDICAL CERTIFICATE.
IL
I, the undersigned, hereby certify, That I separately visited and
personally examined the person named in the an-
nexed Statement and Order, on the Day of
One thousand eight hundred and and that the said
is of unsound Mind, and a proper Person to be
contined.
(Signed) Name .
Physician, Shines, or Apothecry
Place of Abode. . .
I.
I, the undersigned, hereby certify, That I separately visited and
personally examined the person named in the an-
nexed Statement and Order, on the _———_—sédDaary ‘off’
One thousand eight hundred and and that the said
is of unsound Mind, and a proper Person to be
confined.
(Signed) Name . .
Physician, suepeany: or Apothecary
Place of Abode.
The proprietor, or medical superintendent, is required
to send a copy of the order and medical certificates to
the Inspectors of Asylums within two clear days from the
admission of the patient. Subjoined is the form required
to be sent in :—
LUNACY IN IRELAND 193
NOTICE.
Sir,
_ Tam to acquaint you, That’ 3 was received into
my House on the Day of and I herewith
‘transmit a Copy of the Order and Medical Certificates,
(Signed)
To the Inspectors of
Lunatic Asylums in Ireland,
The Inspectors of Asylums preserve copies of orders
and certificates, and enter‘in a register, within five clear
days, according to the following form :
Form or Boox or Entry or Parrents TO BE KEPT IN THE
Licensep Hovszs, ann oF REGISTER TO BE KEPT BY THE
InsPEcTORS.
Cured,
Occupa-| Place es not
tion or of
Dis- | 4 | Death
Profes- | Resi-
charged [oT incu-
ther married or single
Patient, and by whose
of Patient, and whe-
~ Authority sent
by Inquisition
sion dence rable
Surname and Christian
Names, Sex and Age
Date of Admission of
cates, and by whom
Date of Medical Certifi-
signed
Whether found Lunatic
The Inspectors of Lunatic Asylums in Ireland are
required to transmit to the registrar a copy of all medi-
cal certificates within two days from receiving the same,
and in the event of a patient having been admitted into
an asylum upon the warrant of a justice, a copy of the
certificates upon which such warrant was issued must
be sent within two days from the signing of this warrant
0
Registers
kept in
licensed
houses.
Documents
forwarded
to the
registrar.
Book kept.
by medical
superin-
tendent.
Return to
be made by
medical
superin-
tendent.
Escape of
patients.
194 MANUAL OF LUNACY
to the registrar; this must be sent either by the justice
or his clerk.
The medical superintendent is required to enter in
a book kept for the purpose, within three clear days
from the reception of a patient, particulars relating to
the following facts:—Name of the patient, Christian,
surname, occupation, place of abode of the person by
whose authority the patient was sent.
The resident medical superintendent or manager of.
any district, county, or other public asylum, proprietors
of asylums, and all persons receiving lunatics into their
houses are required to transmit by post to the registrar, .
within one week from the reception of the patient, a
notice or return stating his own name, description, and
residence, the name, last known residence, and descrip-
tion of the person.upon whose authority the patient had
been received, the names of the medical men certifying
to the insanity, the age, nature of the Junacy, and pro-
perty of the patient, together with all such other circum-
stances as the Lord Chancellor may require information
upon. Notice of the patient’s discharge must also be
transmitted to the registrar.
Escape, Removal, or Death of a Patient.
The proprietor or superintendent must transmit,
within two clear days, to the Inspectors of Asylums
notice of escape, removal, or death of a patient; and, in
the event of an escape, the circumstances connected with
it, and the mental condition of the patient at the time.
The patient can be recaptured and brought back to the
asylum upon the original certificates. Notice of this
recapture must also be sent, within two days, to the
Inspectors of Asylums.
LUNACY IN IRELAND 195
Form or Notice on Discuarcz, Removat, or Deatu
or Patient.
T= of hereby give
you Notice, That of a Patient
in the licensed House situate in was re-
moved therefrom by of for Death]
on the Day of One thousand eight
hundred and [here describe the State of Mind on
Removal].
"Dated this Day of __One thousand
eight hundred and
(Signed)
To the Inspectors of
Lunatic Asylums, Ireland.
If the patient has been removed, the notice must
state by whose authority, to what place, and the mental
condition at the time of removal.
All licensed houses which are not kept by a medical
man are required to be visited by a medical man once
a fortnight. He is required to make entries in a book
kept at the asylum, and these are to be placed before
the visiting Inspectors at the time of their visitation.
Tf a house is licensed for less than eleven patients,
the Inspectors are empowered to order it to be visited
once every four weeks.
All licensed: houses are visited at least every six
months by one of the Inspectors, who may be accom-
panied by a medical man, if the Inspector wishes it,
and paid by him out of funds placed at his disposal.
At this visit full enquiries are made into everything
connected with the asylum and the patients confined
therein ; and it is required that a “ Visiting Inspectors’
Book” and a “ Patients’ Book” must be kept in all
licensed houses; and entries in both of these made by
the visiting Inspector at the time of his visit.
The Inspectors of Asylums must carefully examine
02
Death or
removal of
patient.
Visitation of
asylums by
medical
men.
Visitation of
asylums by
Inspectors.
Single
patients in
private
houses,
Proceedings
prior to
Commis-
sion in
Lunacy,
196 MANUAL OF LUNACY
and consider the cases to which their.attention has been
specially drawn with reference to the sanity ; and after
two visits, fourteen days having intervened between
them, the Inspectors have legal power to discharge the
patient. In these visits the Inspector may have the
services of a medical officer connected with the nearest
district asylum.*
Single Patients Confined in Unlicensed Houses.
No person (except he be a guardian or relative who
derives no profit from the charge, or a committee ap-
pointed by the Lord Chancellor, or a person with whom
such lunatic has been placed by the committee) shall
receive into his house a person of unsound mind with-
out first obtaining an order and two medical certificates,
as are required previous to the admission of an insane
person into a licensed house.
It is required for the person who receives the patient
to send a copy of the documents upon which he has
been received within three months of such reception to
the Inspectors of Asylums; and on January 1 in every
year, or within seven days from that time, a certificate
must be sent to the Inspectors, signed by two medical
men, describing the mental condition of the patient.
In case of any action, the order and medical certifi-
cates upon which the patient has been received may be
pleaded by the proprietor of the asylum as sufficient
justification for receiving and detaining the patient.
Any person receiving a person of unsound mind. into
his house without conforming to the law is liable to an
action for misdemeanour.
Commissions in Lunacy.
The Lord Chancellor, upon receiving a petition sup-
ported by evidence and affidavits for enquiry into the
* This does not apply to persons found lunatic by Inquisition.
‘
LUNACY IN IRELAND 197
be |
capability of a person to manage his affairs, directs
such inquiry to be held.
The alleged lunatic, if within the jurisdiction of
the Chancellor, must have notice of the presentation of
the petition for enquiry; and may, by a notice signed
by him and attested by his solicitor, and filed with the
registrar within. seven days after such notice, demand
an enquiry before a jury; but before the Lord Chan-
cellor orders the enquiry to be so held he may examine
the alleged lunatic as to his being mentally competent
to form and express a wish for such enquiry.
When a jury.is not demanded, or when the Lord
Chancellor by personal examination is convinced of the
inability of the alleged lunatic to form an opinion, the
Lord Chancellor is required to hear the case; and
having taken evidence upon oath and otherwise, and
called for such information as he may think desirable,
he declares whether the alleged lunatic is or is not
of unsound mind and incapable of managing himself
and his affairs. The Lord Chancellor, when the case is
to be heard by a jury, may order it to be tried before one
of the Superior Courts of Common Law in Dublin.
The order of the Lord Chancellor and certificate of
the judge are to be deemed as an inquisition. If the
lunatic is not within the jurisdiction of the Lord Chan-
cellor, the enquiry is held before a jury, and the alleged
lunatic receives no notice of it. /
All affidavits made in connection with Commis-
sions in Lunacy must be divided into paragraphs, num-
bered consecutively, and expressed in the first person
of the deponent. :
The person having been pronounced to be of un-
sound mind, a committee of the person and estate
is duly appointed, who will protect the interests and
well-being of the patient.
Inquisition
with jury.
Inquisition
without
jury.
Affidavits
connected
with Com-
mission.
Appoint- |
ment of
committess
198 MANUAL OF LUNACY
OFFICE OF INSPECTORS IN LUNACY.—DUBLIN CASTLE,
Inspectors of Lunatic Asylums—Joun Noucznt, B.A., M.D.,
L&R.CS.L, Rutland Square, Dublin; G. W. Harcuett, M.D., L.K.,
Q.C.P., F. R. C.8.1.
Clerk —W. J. Corzzr, Esq. ; J. Lownpzs, Esq.; W. C. Moone,
Esq.
The following is the usual summary, showing the
number of insane on December 31, 1872, and where
located, contrasted with the previous year’s statement :—
1871 1872
In Public Asylums. . .« « «© « 6 6,992 7,140
In Private do. . . . . 7 . . 652 648
In Gaols . so . . . . . a 2 =
In Poorhouses . . . z ‘ 2,914 2,966
In Lucan, supported by Government ‘ . . 35 30
In Central Asylum for CriminalLunatics . a 172 175
Total number of re eeret a . . 10,767 10,959
Lunatics at large . . . 7,560 7,219
Total number of insane in Ireland . a . 18,827 18,178
Number of insane persons in asylums, Jan. 1, 1873 - 7,999
Admitted during 1872 . . . . . ‘ « 2,468
Recovered r ‘ ; ‘ , é ‘ » 1,098
Died . ‘ : 7 < : ‘i 5 : . 670
199
LUNACY IN IRELAND
|
Pot ucon eel Fe |L jee |e jt is jor y* [ot lor |** lorie |r| fre |x lee je |ee}z > |** {p | ‘op‘esnoxpveysdorer,
“wBOUN “ICITF j9T [22 6 [Fe |6L 2 [Sr jet ie is feel *|"* te lox fee it | ft 6 |p |¢ | Op ‘esnoy wequre,y
“queqsts d : ana
“se ‘0 {uubted ete io [tit iniclette fie fs Helo |g |e [eefestefestsleete fe [ele de tl { gumog‘asnony wosegr
pea : “+ YseuLry
‘s88ry iq’ * UO MMOL jor |"* ie jelly fe tt le fe fecfect flor or te le [ola fo tt Lag ‘eBport esmn0g
0
{as 2 Auwex ty
, dag *z ge ee fr safenfoefecles oe qunog ‘uAOITTE
preddeg*id\s |p |e |t Tj |b 1% L |p |e L |p |@ Soeur EM baeapens
. “40D
“Byarp ‘Iq “THE "ACy/GS JOT [eT Jo |e (SE fe JB jor jo fe |r-|-*|-los for jer |refo*fe|efe}esjor fe |e fet fe |e Lenmae “erepestto
| * “op
6§ |9G |ST OT {IT/¢ |S jot |9 |e fe jo {*'}*"|'* lee jos let je Ir lt |e Io |t ie lat 2 ltr le IP 1 Seater Plegmoorg
i "urquq Aqunog
Saag; | euoe PIOWEL “MMC/zz 9 [12 fer fe fore |e |e jo |r- lo feefeefeeles fo tee lett lel tes lo let le |e le iigamee onasyog
qsemary s4yun09
madaey aq)’ = * = WeLTy “AWLize [pT fee jor ig |@ et jz |r is |e fe fe te |srlee for fee fe lec feels slor le Ire los Io TH qeamen yseury
Le |W) Law) L) a |W) oa [Wola Ll) a || dial Lain cl ala) | @ i
eS | Spe ule] # | ¢
i a ese Bee! ce é
uvrorsdqg 3 gs s cS a i 2. =
SUHISTA rojorAdorg STPIOL, 4 a = 5 s[eqOL, = g & sumpssy
oO .
2 oO
a | & | Fie
‘aby nay) pun,*T LRT ‘Tg sequesag uo sumgphsy oyvant gy w syuoung fo waqunyy oy Buamoys 979QD J,
MANUAL OF LUNACY
200
Zag eveloreloot'sz|tsleczlosr|etrleerjort oat LT selego avelore L ST 6F/ST/LE 217loTz|20z|291|201\09 - sTeq0.L
| 4 ‘ * © pro:
camomm mae ft fe fe ele ete ie de fey fet cefecleledeedg fe fe fee fe Leahy Soe
o¢ fog | le Ie Irie ae |r* fee fee foot [ee |eelos fog foe eye] fe] [om om |* [oF fom |**] “op “Baweoura “ag
sqoudg acer jot |*t ie je¢ {elo fo te de de feeder epecion fot po fe fe fc] pep ior fon ft (e fe [cysmama oD “ormazeA
: ‘8s Aaty
gztigo |¢9 (2p lezleriee |1z |g jze |6 |st\"*|*"]""|stleo [so |Z |*"|T |F |S |T jA1T|99 19 9 [FP 1% {anna “(8.qylMg)
i S,Horaqed ‘49
, oF ‘i se aisles a6 well [se ext ie . *umqnq A4uno;
STOID "IC Aopuvyg ‘SIWIOT |9 | |F |S |S |o |% yr | 1% or jo iF T 8 |¢ |& jt {Tt seniors mactepaeOtG
at sare ‘ aofeales eels sig ie Aymn0Q s,ueenh
: qoovr d ‘Id|2I |r |s |s ele is |e |p {tL e or | 8 3 |''% le @ |2 | ie ieee ‘DUDE
gg \rp ze let i |e |tz fpr J2 [et [2 [9 (TroT\9zIss |TF |b |9 /€ |@ ITPPT|La)LF hs [LT °° |"* |°* * ‘op “edg weon'y
sqooery *aq|* sexe uremia ig [tt ie |e ttle |t sete ig jeoetteferie je [rt tefeslecleeienia le [ee dg eae ++ lurqnq*og ‘esnoxrersry
. -gutogso uyor ‘xqlgg let loz lot |¢ lorlet jo 2 jz |p je [rc] ]tt|ee fat joa J f'|t foc] sy jst |e OL Or Jor |6 |200 44umop ‘oprapury
et alert: le fella lo |e le le tye} ten den fe vleelelelelty ter [ee te ft |e] op ‘esnogr pregmsrg
*yous'T 1 . o ie or et leecdeele i sale [eolactes . ve . * aqua
ously ‘1d |ee eg |e & [PL FL [el aq ee fay z 61. 6T \IL Il { ‘op “esnoET DOU
| afme) ao jape| x) 2} we) a | a be) cjabe 2) a) TM) Lt|W) L| af |W] Lo) a jw
° s % d [c} Pe tl Q
a $ s | 2 Ble | é 3
ueposéy 3 2 5 3 3 S
BUITISEA. roqordorg STeq0L i ? i 5 speqoL, e z ® sumpssy
8
a a 5 g
“CHONILNOO—Sab Pp nay, pum “TART ‘TE sequoocag uo swnplisy ayoamg uw spuayng fo saquanyr oy) Burmoys 9190],
201
LUNACY IN IRELAND
fsoyoem'c |* * Attowog~gsorsigmg [+ * * ao AHI | * PoHOWAA | * “ PxOHOFEAL
pooysnoy *¢ ‘ omT‘s*a a |* * * mmAPUgor Id |* { en “8s O8FIS
(‘3ing) seysny UyOL Sewel ‘HM VI “assy AAOBPOTM, ;
sokeH ‘a 'L |* * { syueg “ft { . txgrer qdasog * at manor j puommory
Tony, "Y “AC seem
rIouary, slouvlg =| * % * uosdmouL ‘Hid | * , qsoM *¢ slouRLT "Iq { u ple at $ * yseugQ
proysu0'T
"CW ‘U0 PPIA "UA | * z * gosnsieg‘sop*-Iq |* * ‘* Aapyg'H Ad |° Weel foes * * TesuT MPL
u
ema ‘e | otf) 6 BSOMOx Hyd [°° * Mosyeqoy ‘otra | ° lawaseneret * — weySenoyt
: " 3 .
emuemen ‘ate |* * * ‘!qoerea'a |* * °* TeuwH Hea | ° {. sen Ysnorogéreypy
some “f° . . . * OTM ‘Ss “IC . . . * TWTMS “a IC . . . s100q, AuepuopuoT
guuH Ss | ° : * aosstey ‘4q0y “Iq | * . preteszqiw ‘Iqoy “Id | * ° HOMeury e SOPOUyT
dojuug ‘AM |° e = * omsy ‘rid |° * ' someq ye id |° : yesou0g - Acmmoy 109901
suOTUISZg “ae | ¢ s * epyour oT | * o * f£uvpoq sueg ‘iq | * * £UUOATSL ; i AUTONET
qoutod,W ‘0.0 . . ‘CN “aIgIID EMT . . . ‘om Agcy “~ . . . ATID 3g AOUILTDL
ayooj ‘ma |* °° am seduqen |* * CET "AL | * + paopmem | + Aqqnoosau
‘am eung:a |: “aaunmo wet |! ta toxea a ttt neg : Stuur
a * Kyouoovwp[ “ML Id | * s wou, “4 49 ‘D Id - yorgedumog
r OLLIOYL “Ss “VV “Ad “4s ‘ 7 - 0%
+ + puaysMMOT, ‘OM “AC amelie nee nr 4109 3109
ipthe N
weqery ‘putty + udu emia |° { Bee ae = eae . kivoddyy, | °° Temuorg
. . weplor *e WIG * wospunupy fig | * * + osenr i * reqerysep
waged |* * + BIBeLO SOUL Ia | * * qOLMOR dW IC > feree|| © * wong
eL00yy ‘see ‘ * oeUIIOQOy *H ‘Id ‘ + qremoig qqoHaqd j°¢ wLyUy " * qsezogt
fos 8 moma sound f° OW oqe_ gory |: { eel + sojseuneg
‘+ surg ‘soun‘id |* * ‘GW ‘Ausurpoyrsqoy + * yseury | * * ysemty
Axwooyjody ‘qupedng ‘shy ‘soy sors owisig
‘Bing puv ‘shqd ‘StA pue ‘qjasutOp|
Suqspiduoo saryun0g
202
MANUAL OF LUNACY
Asylums Maintained Wholly or in Part from Charitable
Resowrces.
Asylum Superintendent | Visiting Physician | Apothecary
Bloomfield Retreat . . . Dr. Wharton. _ —
St. Vincent’s Hospital | . . . Dr. T. Fitzpatrick. —
Swift’s Hospital . | Dr. E. Lawless | Drs. J. Hamilton and
Freke . . .|d. Nicholls
Lucan Spa . . | Dr. F, Pim Dr. H. Stewart. —_—
Further Duties of Inspectors.
The Inspectors are also Commissioners of Control
with the two Commissioners of Public Works in Ire-
land. In them, as trustees, are vested all the public
asylums in Ireland, lands, furniture, &c. They have,
under the Lord-Lieutenant in Council, full power to
erect new asylums, enlarge others, take or purchase
more land, divide districts, &c.
LUNACY IN FRANCE 203
CHAPTER XIII.
LUNACY IN FRANCE.
Aut Departments in France must provide a public
institution to receive and treat insane persons belong-
ing to that Department; or else make an agreement,
having previously obtained the sanction of the Minister
of the Interior, with a public or private asylum, in the
same or adjoining Department, to receive their insane
pauper patients.
It is, however, lawful to appropriate a separate divi-
sion in civil hospitals for persons of unsound mind, if
there is sufficient accommodation for not less than fifty
patients.
Lunatic asylums are now under the immediate
direction of the Préfet of the Department, the President
of the Tribunal, the Judge of the Peace, Mayor of the
Commune, and the local Procureur Impérial. It is the
duty of the Procureur of the Arrondissement to visit
every asylum once every six months, in addition to other
visits made by the Préfet, accompanied by other official
persons chosen by himself or by the Minister of the
Interior.
Before an asylum can be opened for the reception of
lunatics, it is necessary to place before the Minister of
the Interior the rules intended to be made use of in the
management of that asylum.
No person can superintend or organise a private
asylum in France without having previously obtained
the approval and sanction of the Government.
Department
in France to
contain an
asylum.
Asylums
under the
direction of
the Préfet,
Regulations
respecting
asylums.
Appoint-
“ment of
medical
officers of
asylums.
Licences for
asylums.
204 MANUAL OF LUNACY
Asylums in France must be used exclusively for the
treatment of the insane.
The Procureur of the Arrondissement is required to
visit the private asylums in his district every three
months, or more frequently if he thinks necessary. The
Minister of the Interior, Préfet of the Department, and
five members appointed by the {Préfet and acting as
Commissioners, have the direction and administration of
all public asylums.
The Minister of the Interior has the nomination and
appointment of the superintendent of such asylum, and
also of the physicians attached to its but if a vacancy
afterwards occur in any of these appointments, the
Minister selects from a list of three candidates proposed
by the Préfet. The Minister has power to revoke the
appointment of the superintendent and physicians,
should he think fit to do so, upon the report of the
Préfet, and he determines the stipend of all officers con-
nected with public asylums. The principal medical
officer connected with the asylum must reside on the
premises, unless special permission is obtained from the
Minister to reside elsewhere. If this permission is
granted, he is required to visit every day all the
patients confided to his care; or, if he is prevented
from doing this, then a daily visitation must be made
by a resident physician.
Licences.
All persons desirous of obtaining a licence to open a
private asylum must petition the Préfet of the Depart-
ment in which the proposed asylum is situated. It
must be satisfactorily proved that the petitioner has
attained the age of twenty-one years, is in the enjoyment
of all his civil rights, that his conduct and morals
have been good during the three previous years, and,
lastly, that he has graduated as a Doctor of Medicine.
LUNACY IN FRANCE 205
When the petitioner does not possess that qualifi-
cation, he may produce a, certificate from some physician
who undertakes to reside in the asylum, and to dis-
charge the medical duties. The certificate that is pro-
duced must obtain the approval of the Préfet, who has
power to revoke such nomination should he think fit
to do so.
Besides the official persons before mentioned, there
are two Inspector-Generals and one adjoint Inspector,
whose special duty it is to visit all lunatic asylums, and
report to the Minister of the Interior with regard to the
condition and management of the insane.
There are at present two classes of patients in
French asylums—Ist, voluntary ; 2nd, those designated.
@ office.
1. Voluntary Patients.
Before a patient can be received into an asylum in
France, it is necessary for a petition to be presented to
the authorities by some near relative of the alleged
lunatic. Accompanying this document there must be a
certificate of a legally qualified medical man, who will
state that the patient is insane and requires confinement
in an asylum.
The chief symptoms and characteristic features of the
mental condition of the patient must be mentioned in
the certificate.
The medical man who signs the certificate must have
seen the patient within fifteen days from the day of sign-
ing the document, and must not be related to the patient
or connected with the establishment to which the patient
is to be sent. This preliminary step may, however, be
dispensed with in very urgent cases, where the patient’s
safety or that of the public is in danger, but it must be
remedied by subsequent proceedings. After the admis-
sion of the patient into the house, all documents respect-
Residence of
mm
edical
officer,
Visitation of
asylums.
Prelimina-
ries prior to
admission of
a patient
into an
asylum
Dangerous
lunatics.
Alleged
cases of in-
sanity.
Special pro-
vision for
dealing with
alleged cases
of insanity.
206 MANUAL OF LUNACY
ing the case must be transmitted to the Préfet of the
Department within twenty-four hours.
2. D’ Office, or Judicial Lunatics.
The Préfet and certain public officers have power to
order the admission into an asylum of any interdicted
or non-interdicted persons considered as actually insane,
in order to receive proper treatment; it is also in their
power to confine any person whose mental condition is
such as to endanger the public safety or to compromise
public order.
The Commissary of Police or the Mayor of the Ar-
rondissement are empowered to place dangerous lunatics
under restraint, provided an authorised medical man
certifies such to be the case.
In these cases it is necessary to report to the proper
officials, who, if they think it necessary, will make addi.
tional enquiries, and act accordingly.
Alleged Lumaties.
When a person in the middle or upper classes of
society is supposed to labour under mental disorder, it
is customary to assemble a consetl de famille, who, after
having examined the alleged lunatic and investigated
thoroughly the whole case, will draw up a procés verbal
of the facts to be placed before the Procureur Impérial.
The Procureur will now order two medical men to
visit the patient separately, take evidence, and after-
wards forward to him their opinion of the case. Upon
the written opinions of these physicians the Procureur
gives his judgment, and the patient is sent to an asylum
or otherwise treated as he may decide.
Though this is the usual way of dealing with alleged.
lunatics, there is a special provision relative to the
management of sudden cases of insanity. If a legally
LUNACY IN FRANCE 207
qualified medical man believes that a patient under his
care has become suddenly insane, so as to render himself
dangerous to others or to himself, he may at once convey
the patient to a maison de santé, and there leave him,
with one certificate of insanity, in which certificate is
embodied the full particulars of the case. The proprie-
tor of the asylum to which the patient has been taken
must forward immediately a statement of every fact
therewith connected to the Inspector-General of Luna-
ties, who shortly afterwards will send two physicians to
examine the patient separately, and to report every fact
connected. with the case. Upon these facts the Inspec-
tor-General will make his decision. /
I will give one case, taken from Dr. Webster’s inter-
esting paper upon the Lunacy Laws of France, published
in Dr. Forbes Winslow’s Psychological Journal, as an
illustration.
An English nobleman consulted a medical man re-
siding in Paris concerning his health, and having de-
scribed certain symptoms which led the physician to
suspect that his patient was of unsound mind—exhibited
chiefly by his great excitement, and by the patient pro-
ducing from his pocket a bowie-knife with which he
threatened to kill a certain person—the physician, after
some conversation with the patient, induced his lordship
to take a drive, as if for recreation; the patient was
forthwith taken to a maison de santé, and there safely
lodged, with one medical certificate. The Inspector-
General, having been speedily informed of this occur-
rence, ordered two sub-inspectors to investigate the case
and report their opinions thereon. Every legal formality
being thus readily complied with, and as the patient was
found to be unmistakably insane, he remained there un-
der treatment until discharged convalescent.
By this rapid way of procedure, public scandal and
‘Condition of
“insanity
during the
late war.
208 MANUAL OF LUNACY
unnecessary violence, frequently accompanying acute
cases of insanity, may be avoided.
Statistics of Insanity in France.
On January 1, 1870, there were 38,036 lunatics, ex.
clusive of idiots, residing in French asylums. On
January 1, 1871, the number was 38,100; on January 1,
1872, the number of lunatics registered was 37,323.
Dr. Lunier, in a paper read before the Académie de
Médecine upon the question of the influence of the
events of 1870-71 on insanity in France, discusses the
subject as to whether political and social commotion
occurring in the country contributed to increase the
number of the insane. We see by comparing the above
statistics that the number of the insane in France on
January 1, 1871, was 64 less than at the same time the
previous year; and that on January.1, 1872, it was 718 .
less than in 1870.
Dr. Lunier, in his interesting paper, mentions the
fact that the number of patients admitted into the asy-
lums of France from July 1, 1869, to July 1, 1870, was
11,655; and that in the following year—that is, during
the Franco-German war and the reign of the Commune
—the number decreased to 10,243, or 12 per cent. less
than the previous year.
During the last six months of 1871 the number of
patients admitted into French asylums was higher than
during the corresponding six months of 1869 ; but never-
theless the number remained notably below what it
would have been had the increase been followed by the
smallest decrease of the preceding years. Out of the
10,243 patients received into French asylums from July
1, 1870, to July 1, 1871, 13 per cent. became insane in
consequence of the events of 1870-71. Out of this
number, viz., 1,322, 15 per cent. were men and 9 per.
cent. women. During the last six months of 1871, 400
LUNACY IN FRANCE 209
patients were admitted into French asylums who had
become insane in consequence of the events of 1870-71,
8 per cent. being men and nearly 6 per cent. women.
Dr. Lunier states the following facts:—The events
of 1870-71 have therefore produced two apparent con-
tradictory results: they have caused the outbreak of
from 1,700 to 1,800 cases of insanity, and yet they have
led to a decreas of more than, 3,000 in the number of
the insane.
The principal causes for this paueads seem to be the
‘disturbance caused by the invasion in the organisation
regarding the insane; the diversion produced by these
‘events in the minds of a certain number of persons pre-
disposed to insanity, in certain parts of the country; the
momentary decrease of excessive drinking of alcohol;
and lastly, the rapid termination by death, or, much
more often, by recovery, of the insanity caused by the
- events of the war.
Insanity in France.
The population taken at the last census was
37,988,905.
Number and Distribution of the Insane.
Sate Insane Idiots Totals
Ta asylums . . . . 81,992 3,980 35,972
At home Se: (oh eee 18,734 35,9738 - 64,707
Totals . . . 50,726 39,953 90,679
Males Females Totals
Insane . . - e+ 24,190 26,537. 50,726
Idiots . . «© «© 22,7386 17,217 39,958
By this it is seen that there was one insane person.
P
Dr. Lunier’s
remarks
upon the
condition of
insanity
during the
war.
210 MANUAL OF LUNACY
in every seven hundred and forty-seven of the population,.
and one idiot in every nine hundred and fifty.
According to the official records the chief assigned
causes for insanity in France were, epilepsy and convul-
sions, intemperance, destitution and misery, loss of for-
tune, and hereditary predisposition.
List of Asylums in France.*
Where situated
Names of Directors
Department Commune
: Berger
ain Bourg Bourgarel
Aisne Prémontré Viret
Allier Ste. Catherine, com-
mune of Yzeure Chasseloup of Chatillon
Ardéche Privas Nier
Ariége St. Lizier Sisteray
Aude Limoux Joly
Aveyron Rhodez at
5 “Guignar
Marseilles 2 5
Dubiau, Hildoubrand,
Bouches-du-Rh. ‘Abra
Aix . | Pontier
Lallier
Calvados Caen Is ‘Vatel, Faucon, Caron
Cantal Aurillac Meynial
Charente Breuty, near Angou-
. léme Binet
Charente-Infé- Lafond, commune of
rieure Cognehors Arnozan ac
Renault of the Mote
Cher Bourges -Lhomme, Brunet y
Corréze La Cellette 1. | Burin
Céte-d’Or La Chartreuse, near
Dijon : Fougéres, Max Simon
Cdtes-du-Nord Lehon, near Dinan 1, ioe
St. Brieuc 2. | Grosvallet
Eure Evreux Védie
Eure-et-Loir Bonneval Broe
. Morlaix (female) 2.| Barazier-Lannurien
Finistére 18 Athanase, near
Quimper (male) Baume
1, Asylum not connected with a Hospital.
2, Connected with a Hospital.
* This list is taken from the Medical Directory of France, published in 1872.
ASYLUMS IN
FRANCE.
211
List of Asylums in France—continued.
Where situated
1, Asylum not connected with a Hospital.
P2
: : N of Directors
Department Commune
Garonne (Haute-)} Toulouse Marchand
Gers Auch Bouteille
, ’ Bigot
Bordeaux (female 8
Gironde ) eat
Cadillac (male) Péon
| Héranlt Montpellier 2. | Cavalier
| Ille-et-Vilaine St. Méen Cientee Laffitte
| Indre-et-Loire Tours Danner
Isére * St. Robert, gan Pinot
mune of St. Egréve Gout
| Jira Dole Rousseau
‘| Loire (Haute-) Le Puy 1. | Ramadier
' Loire-Inférieure | Nantes 2.) Petit
Loiret Orléans 2.| Payen \
Loir-et-Cher Blois Leese ‘
Lot Leyme 1. | Bonnefous
Lozére St. Alban Campan
| Maine-et-Loire Ste. Gemmes, near
Angers Combes
Manche Pontorson Sizaret ;
Marne . Chélons Renault du Motey
Marne (Haute-) | St. Dizier Lapointe
Mayenne Laroche-Gandon,
com. of Mayenne Bonnet (H.)
Meurthe Marévillenear Nancy haat Petrucci
Meuse Fains,nearBar-le-Duc ae al
Morbihan Vannes 2. | Pelé de Queral
Niévre La Charité Brunet
Armentiéres (male) cane Dufour
Nord lon
Bailleul (female) Leblond
ae Espiau de Lamestre
Labitte
Oise Clermont 1.14 Pain
Orne Alengon a
i iraut
Pas-de-Calais St. Venant Florim ond
2, Connected with a Hospital.
-212
MANUAL OF LUNACY
List of Asylums in France—continued.
Seine-et-Oise
Seine-Inférieure
| Sevres (Doux-)
Tarn
Tarn-et-Gar
Vaucluse
Vendée
Vienne -
Vienne (Haute-)
Yonne
2.
Bicétre (male)
Salpétriére(female)2,
Asylum of Ville-
{ Evrard
Asylum of Vaucluse
i= Quatre-
Mares (male)
Rouen, St. Yon (fe-
male)
Niort
Alby
Montauban
Avignon
Napoléon-Vendée
Poitiers
Limoges
2.
L
2.
1.
Auxerre
‘Where situated
Names of Directors
Department Commune
Puy-de-Déme Clermont 1. | Hospital
Pyrénées (Bas.) | Pau ee
Rhéne Lyon(Antiquaille) 2. | _Arthaud Lacour
Barthélemy
Sarthe Le Mans Etoc-Demazy
Savoie Bassens ier
Bayeux
Asile Ste. Anne (clini- oe Lines
agonet
eal asylum), Bouchereau
Seine Megumi
Berthier, J. Falret, Le-
grand of the Saulle
Delasiauve; Moreau,
Trélat, Voisin
Dagron
Billod
\
Dumesnil
Maret
De Lagonde
Morel de Gany
Delaporte
Lagardelle
Cassan
Darnis
Cottard
Campagne
Guérinau
een
Talia
Poret junior
1, Agylum not connected with a Hospital,
1
2. Connected with a Hospital.
PRIVATE ASYLUMS IN OR NEAR PARIS. 213
ie
Private Asylums in Paris and its Vicinity.
Paris.—808 Rue du Faubourg St.-Antoine. Founded 1769. The
first entry is 12th June, 1769. Proprietary and Medical Officer, Dr..
Brierre de Boismont.
Near Paris—106 Grande Rue de Saint-Mandé (environs of
Paris). This Asylum is exclusively for ladies mentally afflicted.
Proprietress, Madame Rivet, née Brierre de Boismont. Resident
Medical Officer, Dr. Correggere. Consulting Visiting Physician,
Dr. Brierre de Boismont.
Paris.—161, 163 Rue de Charonne. Directors, Dr. Mesnet,
Physician of the Hépital St.-Antoine, Dr. Motet, both residing.
Paris—10 Rue Picpus (Asylum of Marcel Sainte-Colombe).
Director, M. Conderc, assisted by Dr. Dassonneville.
Environs of Paris.—59 Grande Rue (St.-Mandé); 19 Avenue de
lEtang.
Maison de Convalescence.—Madame Albert Brierre de Boismont.
Visiting Physician, Dr. Brierre de Boismont.
Paris —90 Rue Picpus (Asylum of Reboul Richebraques).
Director, Dr. Rota. Consulting Physician, Dr. Tardieu, 364 Rue St.-
Honoré.
Vanves, near Paris —This Asylum was opened in 1822. Proprietor,
Dr. Voisin (since dead) and Dr. Jules Fabret ; however, the Asylum
is always under the name Voisin and Fabret; also 114 Rue du Bac.
Jules Fabret is alone connected with the Hospital of Bicétre.
Iury-sur-Seine.—(Asylum of Santé-Esquirol), 7 Rue de Seine. Di-
rectors, Dr. Baillarger, 15 Quai Malaquais, Paris. Dr. Moreau de
Tours, 17 Rue Bonaparte, Paris; Dr. Luys residing. These three
physicians are consulted at 8 Rue de l'Université, and they are con-
nected with the Hospital of Salpétriére.
Paris.—17 Rue Berton, Quai de Passy. Director, Dr. Meuriot,
ancien interne des Hépitaux de Paris. Consulting Physician, Dr.
Blanche.
Sceaue, near Paris—(Villa Penthiévre, Asylum and Convalescent
Hospital for patients of both sexes). Director and Proprietor, M.
Reddon. Resident Medical Officer, Dr. C. Du Souchay.
214 MANUAL OF LUNACY
Neuilly, near Paris —Asylum of C. Pimel, to the Castle of Saint-
James, Avenue de Madrid. Medical Director, Dr. Semelaigne,
Commissioners in Lunacy (Inspecteurs généraun).
Dr, Constang, Rue du Bae, Passage Ste.-Marie, 11 bis,
Dr. Lunier, 52 Rue Jacob.
Dr, Dumesnil, 75 Rue de Vaugirard. ~
LUNACY IN BELGIUM 215
CHAPTER XIV.
LUNACY IN BELGIUM.
Licences.
No person is allowed to open or superintend an asylum
without obtaining permission from the Government.
All houses in which one or more lunatics are living
are considered as asylums, except when a person is taken
care of by a curator, relative, tutor, or provincial ad-
ministrator.
Before a licence is granted certain facts have to be
clearly established :—
L. The situation of the proposed asylum must be a
healthy one, the interior of the house properly arranged,
and the grounds attached to the asylum tolerably ex-
tensive.
2. The male and female patients must be separated,
and a proper classification adopted.
3. Medical men must be connected with the institu-
tion. The permanent deputation appointed for the
nomination of the medical officers must renew every
three years their approval of the professional attendants.
Admission into an Asylum.
In order to place a patient in an asylum in Belgium,
‘a medical certificate describing his mental state must be
‘obtained; this has to be signed not later than fifteen
days previous to the admission, but cannot be signed by
Licences
required
before re-
ceiving
patients.
Particulars
relative to
the licence,
Prelimina-
ries to be
followed
prior to the
reception
into an
asylum,
Medical
certificates.
Special cir-
cumstances
ander which
certificates
are dis-
pensed with.
Notice of
admission.
Visitation of
patients.
216 MANUAL OF LUNACY
the medical man who is connected with the asylum: to.
which it is proposed to send the patient.
Medical certificates contain an accurate description
of the nature, duration, and characteristic symptoms of
the insanity, stating when the attack commenced, and
whether any previous treatment has been adopted.
A sealed statement by the medical man certifying
is drawn up, containing the following particulars: the
cause of the insanity, and whether any member of the
patient’s family has been similarly affected.
Certificates connected with pauper patients are.
granted gratuitously by the medical officer of the poor.
In urgent cases of insanity this certificate is dispensed
with at the time of admission, but it is absolutely neces-.
sary for one to be obtained within twenty-four hours.
from the time of the patient’s admission.
Notice of the patient’s admission must be sent within:
twenty-four hours to the following persons :—
1. The Provincial Governor.
2. The King’s Procureur of the Arrondissement.
3. The Cantonal Judge of the Peace.
4, The Burgomaster of the Commune.
5. The Committee of Inspection.
6. The Secretary of the Permanent Commission.
Within three days from the reception of the notice
sent to the permanent commission, two members of the
commission who are in the medical profession are re-
quired to visit the patient and examine into his mental
condition.
These visits must be repeated every two months
during the first half-year ofthe patient’s residence in the:
asylum, but during the second half-year the patient is
only required to be visited once.
The results of these visits must be entered in a regis-
ter kept at the asylum, and a copy sent to the secretary
of the commission.
LUNACY IN BELGIUM 217
Hight days after the admission of ‘a patient into a
public or private asylum, a new certificate, containing
the various symptoms and the frequency of the acute
ones, must be sent by the medical officer of the establish-
ment to the secretary of the permanent commission.
The Procureur of the Arrondissement must be in-
formed where the patient formerly resided, so that he is
enabled, through the local officer, to inform the patient’s
friends of the circumstance.
All asylums are visited by persons delegated by the
Government, as follows ;
1. Every year by the Burgomaster of the Commune.
2. Every three months by the Procureur of the Ar-
rondissement,
3. Every year by the Provincial Governor, or a
member of the Provincial Council nominated by’ the
Governor.
Patients in Private Houses.
No person of unsound mind can be “ sequestrated ”’
in his own house, or in that of a relative, without two
medical certificates first being obtained. One of the
medical men who certify is appointed by the patient’s
family, and the other by the cantonal judge.
The cantonal judge is required, by personal exami-
nation, to satisfy himself as to the insanity, and to visit
the patient every month.
A certificate once every quarter has to be sent to the
judge by the family physician, describing the progress
of the case.
Discharge.
‘Notice of discharge must be sent to the same persons
to whom notice of admission was required to be sent,
‘within twenty-four hours from the discharge.
The notice contains the patient’s name, the asylum
Lunatics in
unlicensed
houses must
be under
certificate.
Discharge of
patients.
Classifica-
tion of
patients is
required by
law.
Asylums are
required to
have medi-
cal officers
connected.
with them,
Commission-
ers’ report,
218 MANUAL OF LUNACY.
71 which he had been confined, his mental state at the
time of discharge, and the name of the house in which
he is going to reside.
Classification of Lunatics in Asylums.
According to the regulations existing, all asylums
containing fifty patients of each sex must be divided
into two separate divisions, viz., Excited and Quiet
lunatics.
If the number of each sex is more than fifty, four
divisions of the patients are requisite, namely: 1. Quiet;
2. Excited and noisy; 3. Idiots and dirty patients; 4.
Convalescent patients. :
In asylums containing more than 100 patients of
each sex, the clean and orderly patients must be sepa-
rated from the dirty.
Medical Officers of Asylums.
Every: asylum is required to have one or more medi-
cal men connected with it, and the patients have to be
visited daily.
One attendant is required for every ten patients.
No person can open an asylum, or make important alte-
rations in any asylum, without first obtaining the sanc-
tion of the Government. 7
The special visitation of all asylums is confided in
each Arrondissement to a committee of five, seven, or
nine members, including the district commissary, who
sits ex officio. These officials are required to visit annu-
ally all asylums situated within their immediate juris-
diction. Besides these local visitors, three Government
Commissioners have officially to visit every year, and
draw up a report containing a detailed statement of all
asylums and everything pertaining to lunacy in Belgium,
and this is published. :
There are fifty-nine asylums in Belgium, three-fourths
ASYLUMS IN BELGIUM, 219
of which are situated in towns or in their immediate
vicirity, and one-fourth in the rural communes.
Asylums in Belgium are usually small, containing
from ten to thirty patients, and chiefly situated at Ghent
and Bruges, or in the immediate vicinity of these towns ;
but these institutions are not well adapted for the treat-
ment of lunatics, in consequence of the small space occu-
pied by them.
LIST OF ASYLUMS IN BELGIUM.
Province of Antwerp.
1, Antwerp. Hospital for patients of both sexes.
2. Antwerp. Asylum occupied by les fréres cellites.
8. Malines. Asylum occupied by les ,fréres cellites for male
pensioners.
-4, Duffel. Asylum for female pensioners.
5. Gheel. Large establishment for both sexes.
Province of Brabant.
1. Brussels. Asylum connected with the Hospital of Saint-Jean.
2, Brussels. Asylum at Uccle for pensioners of both sexes.
8. Schaerbeek, Asylum for pensioners of both sexes.
4, Erps Querbs. Asylum for female pensioners and poor
patients.
5. Louvain. Hospital for male pensioners and poor patients.
6. Louvain. Hospital for female pensioners and poor patients.
7, Tirlemont., Hospital for male pensioners and poor patients.
8. Diest. Hospital for male pensioners.
9. Diest. Hospital for female pensioners.
10. Berthem. Hospital for female poor patients.
There is no public asylum in Brussels, only a small
provisional depdt attached to the hospice of St. John.
This is more like a prison than an insane receptacle.
Inthis place lunatics are temporarily confined, previously
to being transferred to other establishments.
There are some first-class private asylums in the
neighbourhood of Brussels. ‘Two large asylums are
Asylums in
Belgium
are small,
St. Julien
charges for
patients.
220 MANUAL OF LUNACY
situated at Hvére, one containing about fifty-six patients .
and the other about eighty.
« Province of West Flanders.
1, Bruges. Hospital of Saint-Julien, for pensioners and poor .
patients of both sexes. ,
2. Bruges. Hospital of Saint-Dominique, for pensioners and
poor patients of both sexes.
8. Bruges. Asylum of Saint-Michel, for male pensioners,
4, Courtrai. Hospital of Sainte-Anne, for pensioners and poor
patients of both sexes.
5. Menin. Hospital for female pensioners.
6. Yprés. Hospital for pensioners and pauper patients of both
Sexes.
7. Thielt. Hospital for poor patients of both sexes.
The hospital of Saint-Julien is one of the most ancient
asylums in Belgium. It is situated near the railway
station, close to the Porta Santa, one of the gates of
Bruges. Insane persons were received within its pre- .
cincts about 4.D. 1500. It contains about 400 patients,
an equal number of both sexes. The best class of patients
pay from 201. to 901. per annum. The pauper patients
are received at the rate of 111. per annum; this includes
-food, clothing, and lodging.
The asylum is far too crowded, and the grounds too
small for the use of the patients ; there are three medical
officers attached to it, one of whom is required to visit
the asylum every day, or oftener if necessary.
A convalescent home has been erected in the neigh-
bourhood of the hospital, capable of receiving 450
patients. The erection of this appendage is a great
benefit to the lunatics who are admitted into it; they
are enabled to breathe the pure air of the country in-
stead of being shut up in a confined place.
With regard to the hospital itself, which is confined’
to the medical treatment of the patients, a great many
improvements have recently taken place.
- ASYLUMS IN BELGIUM 221
Asylum of Saint-Dominique.
This asylum was formerly an ancient convent, but
has for many years been used as an asylum, There are
five proprietors connected with it, who, in consequence
of the accommodation for the patients being insufficient,
have taken a chAtean called Saint-Michel.
This chateau is about two miles’ distance from Bruges,
and has attached to it a garden, and farm of about 100
acres. About 70 to 80 patients are received in this
building. ;
About 200 of each sex are confined at Saint-Domi-
nique asylum.
The patients are classified as follows :—
1. Convalescent patients.
2. Quiet patients.
3. Excited patients.
4, Noisy patients.
5. Idiots and dirty patients,
The asylum is managed by three physicians and one
surgeon, who appear.to do everything for the care and
amusement of their patients.
Patients who are willing and able assist at the various
employments to be obtained in the asylum.
This asylum has lately undergone complete reorgani-
sation, both as regards new buildings and general ma-
nagement.
Province of East Flanders.
1. Ghent. Hospital of Guislain, for male pensioners and pauper
_ patients. ; ;
2. Ghent. Hospital for female pensioners and pauper patients.
3. Ghent, Asylum situated in the Street d’Assaut, for female
pensioners. .
4, Ghent. Asylum of Strop, for male pensioners.
5. Ghent. Hospital of Grand Béguinage, for female pauper
patients. . e . :
." 6, Ghent. Hospital of Saint-Jean-de-Dieu, for male pensioners.
Classifica-
tion of
patients at
St. Domi-
nique.
222 MANUAL OF LUNACY ~
7. Ghent. Hospital of Selzaete, for male pensioners and pauper
patients.
8. Saint-Nicolas. Hospital for male pensioners and poor
patients.
9. Saint-Nicolas, Hospital of Ziekhuifs, for female pensioners
and pauper patients.
10. Alost. Asylum for male pensioners.
11. Velsique-Ruddershove. Hospital for female pensioners..
12, Lede. Asylum for female pensioners and pauper patients,
18. Ninove. Hospital for poor patients of both sexes.
14, Nevele. Hospital for poor patients of both sexes,
15. Sleydinge. Hospital for poor patients of both sexes.
A new hospital has been opened at Selzaete, at Ghent,
capable of receiving when completed 250 patients.
The asylum of Saint-Jean-de-Dieu, at Ghent, has
been rebuilt and arranged in a manner more suitable
to its situation, The yard has been converted into a
garden containing a fountain, and domestic animals are
kept in the garden, and these serve to occupy the atten-
tion of and amuse the patients.
The number of patients residing at Ghent.or in its
immediate neighbourhood amounts to 700, the majority
of whom are female.
The Province of Hainault.
1, Mons. Asylum for female pensioners and pauper patients.
2. Froidmont. Asylum for male pensioners and pauper patients.
3. Tournai. Asylum for female pensioners and pauper patients.
4, Wez-vel-yain. Asylum for female pensioners.
5. Chiévres. Asylum for female pensioners.
The asylum ‘at Froidmont ranks among some of the
first in Belgium, The pensioners and poor patients
occupy separate and distinct apartments. The division
of the asylum appropriated to the pensioners consists of
two wards, one reserved for the quiet and one for the
noisy patients; and two new wards are in course of
construction for the dirty and excitable patients.
The part of the asylum occupied by the pauper
ASYLUMS IN BELGIUM 223
patients is divided into five distinct wards, for quiet,
half-quiet (semi-paisibles), excited, rather noisy (semi-
agités), and idiots. .
The two divisions occupied by the pensioners and
pauper patients are separated by a large and beautiful
gallery, in which the pensioners are allowed to walk, and
which serves ag an easy communication between the
various parts of the house.
There is a large public hall and refractory ward in
each of these divisions; large dormitories, properly
lighted and well ventilated, are situated on the various
floors. :
In the part of the asylum occupied by the noisy and
idiotic patients the dormitories are on the ground-floor.
The grounds in which the patients take their exercise
contain a number of trees and flowers, over which are
situated covered galleries, and these enable the patients
to be protected in case of rain. A great improvement
existing at the present time is that the various exercising
grounds are separated by hedges, and not by walls, this
helps to remove all idea of seclusion, and allows a free
current of air to pass. There is accommodation in
this establishment for 500 lunatics.
The medical superintendent and his assistant are
nominated by Government.
Province of Liége.
1. Liége. Hospital for male pauper patients.
2, Liége. Hospital for female pauper patients.
8. Ans-et-Glain. Asylum for pensioners of both sexes.
4, Faubourg Sainté-Marguerite, Asylum for pensioners of both
BeKeS,
Province of Inmbourg.
There are two establishments situated at Saint-Trond,
one for male pensioners and pauper patients, the other
for female.
Origin of
Gheel,
Legend con-
mscten. with
it.
224 MANUAL OF LUNACY
Insane Colony at Cheel.
Gheel was formerly occupied: by the Texandrians,
mentioned in Cssar’s ‘ Commentaries,”’ and, according
to tradition, has for a long time been a refuge for luna-
tics. There is a legend respecting the origin of the sup-
‘posed power possessed by Gheel for the cure of insanity,
In the sixth century, Dymphna, a daughter of an Irish
king, was converted to Christianity through the agency .
of an anchorite named Jerebert.
The father was very much enraged at the conversion
of his daughter, and threatened vengeance.
Dymphna and her companion fled across the sea to
avoid the vengeance of her father, who eventually, upon
discovering her retreat, insisted upon her again changing
- her religion. Upon her not consenting to this, her father
Gheel found-
ed 1200.
drew his sword and cut off the head of Jerebert, and
also that of his daughter. :
Some lunatics who were said to be present at this
massacre were very much terrified, and the legend re-
“ports that they were immediately cured. This faith
having spread abroad, lunatics were brought to Gheel
from far and rear, to be cured through St. Dymphna’s
intercession.
About a.p. 1200 a church was erected on the spot
where the murder was perpetrated, in which the bones
of the murdered Dymphna were deposited. In the church
there are several paintings of groups of insane people
chained down, and also oak carvings representing the
circumstances connected with the murder of Dymphna.
There is a small house attached to the principal
church tower, in which lunatics were deposited by their
friends for nine days consecutively. This was the period
considered essential for their recovery.
Nine young virgins, hired for that purpose, made a
daily procession round the church aisles, passing nine
LUNACY IN BELGIUM : 225
times on their bended knees under St. Dymphna’s tomb ;
during this time prayer was offered up for the lunatic’s
recovery. A priest at the same time recited prayers ap-
pointed for such occasions.
Gheel contains a population of about 4,000 ; but that
contained by the whole commune is 9,000. Formerly
1,000 persons of unsound mind were distributed in, or
in the neighbourhood of, Gheel. The number is now
increased to 1,230. These patients are distributed in
about 89 houses; 380 of these are cottages and farm-
houses situated in the country,-and the remainder in
Gheel itself. The district through which these patients
are distributed occupies a circumference of thirty miles,
and is divided into four divisions. Each of these divi-
sions is under the superintendence of a physician.
All householders of the commune who are authorised
to receive lunatics are divided into two classes: 1. Hosts;
2. Nourriciers.
The first of these classes receive patients who pay at
least 25 francs per annum more than indigent lunatics.
The second class, or nourriciers, receive patients at the
minimum rate of payment.
The householders who receive lunatics have their
names inscribed upon a register, and the distribution of
the patients is effected according to rotation, though the
friends of the patients have power to select any regis-
tered person they may think fit to place their friends
under,
Except under certain circumstances only three luna-
tics are permitted to reside in one house; but special
sanction can be granted by the permanent committee to
receive a larger number, after they have received a report
from the divisional and inspecting physicians.
Rules are laid down respecting the food and clothing
provided for the patients, and no patient is allowed tq
work unless he is in a fit state to be employed,
8
Population
of Gheel,
Hosts and
nourriciers
receiving
patients
have their
names re-
gistered.
Preliminae
ries respect-
ing the
admission of
patients into
Gheel,
Charges for
patients
at Gheel.
226 MANUAL OF LUNACY
The hours in which patients are permitted to leave
their domiciles are, in summer, between 6 a.m. and 8 P.m.,
and in winter, 8 a.m. to 4 P.M.
Very stringent police regulations respecting these
lunatics are in force: If one escapes, the person in whose
house he is at the time will have to pay three-fourths
of the expenses incurred in his recapture.
They are permitted to wander about within the limits
of their district, unless any symptoms of violence or a
desire to escape are exhibited.
The patients are first received into the infirmary,
where their symptoms are carefully watched for a time,
before they are entrusted to the care of a nourricier or
host. Those in the infirmary receive proper medical
treatment, and remain there as long as their condition
renders it necessary for them to be under immediate
medical supervision, The medical superintendent has
the power to direct, as he may determine, the removal
of a patient from the infirmary to the care of a nour-
ricier or host, whose duty it is to provide occupation °
for therh. The patients occupy their time in various
ways: some in agricultural pursuits, others in music or
painting. In the event of a severe bodily illness occur-
ring, they are transferred to the infirmary to undergo
the requisite medical treatment,
Payments usually made at Chel.
There are four different classes of payment.
In the Ist class, about 49 patients pay from 161. to
602. per annum.
Tn the 2nd class, about 147 pay at the rate of 151.
per annum.
In the 3rd class, about 266 patients pay at the rate of
131. 5s. per annum.
In the 4th class, about 312 patients pay at the rate
of 112, 12s. Gd. per annum.*
* These reside with the nourriciers,
‘LUNACY IN BELGIUM 227
These payments include lodging, food, clothing, &c.
All patients who are able to work are employed on the
farms and fields, or as ordinary servants. Most of the
quiet patients reside in Gheel, and the noisy and more
excitable ones in the country. About fourteen patients
in every hundred recover, and about fifteen per cent. die.
We rarely hear of the perpetration of any violence ;
suicides are very rare; and morality is less outraged
than in more protected classes.
The ‘ Médecin Inspecteur’ is Dr. Bulckens, who has
kindly sent me full particulars relating to Gheel. He
has it in his power to visit at any hour a patient con-
fined, and, if necessary, order his removal. The sys-
tem adopted here has been generally attended with
favourable results, though much objection has been
raised against it.
Raguingons affecting the Colony. at Gheel.
Gheel is affected by the same laws applicable to
asylums throughout Belgium, being under the inspection
of the Permanent Commission charged with the super-
vision of all lunatics. Besides this, a committee of eight
members superintend the whole establishment.
Four of these members are appointed annually by the
special Commission from their own body, or from persons
resident in the commune of Gheel. The Minister of
Justice appoints four more members, from a list given to
him by the council of the commune.
The Burgomaster or one of the sheriffs presides over
this committee. These officials manage everything, re-
ceive all moneys paid, and are responsible for all pay-
ments; visit the houses in which the lunatics are confined,
and look after their welfare.
On January 1, 1873, according to statistics kindly
forwarded to me by Dr. Bulckens, there were 1,230
Qa
Visitation
and inspec~
tion of
patients
at Gheel,
228 MANUAL OF LUNACY
persons of unsound mind residing i in Gheel and its imme-
diate vicinity.
Classification of Patients at Gheel on January 1, 1878,
Male | Female Total
‘ 572 658 1,230
Natives . . * . { 492 575 1.067
Foreigners, z.e. not Belgians 80 83 163
Pensioners . ’ . : 97. 43 140
Poor patients , : . 475 615 1,090
Curables . : ‘ i 97 43 140
Incurables . 2 ‘ x 475 615 1,090
Admissions during the year 1872, 310 patients.
Male Female Total
Curable. . : . : ‘ 32 53 85
Incurable ‘ : : » | 116 109 226
Total . . . . . 148 162 310
Pensioners . * . < 7 23 12 35
Pauper patients . 7 : . | 126 149 275
Total . 2 . . . 149 161 310
Discharges during Pensioners . 8 5 13
1872 . « Jj Paupers . . 94 91 185
‘Total . www | 108 96" 198
Recoveries. ‘ : ‘ : 31 80 61
Deaths... s . A 35 42 77
Discharged . . . q 20 5 25
Removed by friends ; 5 6 13 19
Escaped. ‘i - é 3 ‘ 10 6 16
Total . : : : ‘ 102 96 198
LUNACY IN BELGIUM 229
The average rate of mortality during the last eighteen
years was seven per cent., but during the year 1872 the
proportion was five per a out of 1,428 cases under
treatment during the year.
The recoveries form but a very small proportion,
because the asylum receives a large proportion of the
infirm and incurable patients from other institutions,
so that the incurable patients form seven-tenths of the
total inmates.
Gheel contains 85 hosts (hétes) and 806 nourriciers,
making in all 891 families in which patients are re-
ceived and treated like members of the family of the
proprietor.
Gheel is situated about thirty-two miles from Ant-
werp; the most direct route is by rail to Herenthals.
This occupies about one hour, and from thence by
omnibus or private conveyance in an hour and a half.
Condition of Lunacy in Belgium.
The last census, taken in 1868, contains the following
particulars relating to the insane :—
. The number and the sex of insane persons in Belgium.
. Their antecedents, and where they were born.
. Their age.
. The age at which they became mentally afflicted.
Their condition in society, and amount of education.
. Their profession.
The number and age of lunatics detained in each establish-
B
oO
wonkhwranrwnpe
. The province in which they were born.
. The province in which they lived.
At the last census, the number of insane persons in
Belgium was found to be 8,240, distributed as follows :—
Rate of
mortality.
“230 MANUAL OF LUNACY
1
In Asylums . Living at home * General Totals |
' Male |Female] Total| Male |Female|Total| Male |Female
Fre... . . | — | — | — |1,280| 850 | 2,120
Deprived of fae 3,953
rr my
Dri vet ecty }| 2972) 3,060 | 6,032| 35] 43 | 78
—_|--—._-—27/
Totals . | 2,972| 3,060 | 6,032|1,815| 893 |2,208| — 8,240
The population in Belgium is 4,897,794, there being
one insane person in every 594 of the population. If
this is compared with the census taken in the four pre-
vious times, it will be found that the increase of insanity
is unmistakable.
- Spulation ~ | One Insane Person
a sooeraing to the in every
18385. a é @ 4,165,953 816
1842. ‘i « : 4,172,706 924
1853. ‘ ‘ ‘ 4,516,361 920
1858. e . . 4,623,300 714
1868 . . ; é 4,897,794 594
I have drawn up a statistical table of the admissions
and discharges from the year 1866 to 1870 inclusive.
The Commission of Enquiry of 1842 visited 37 asy-
lums; in 1852 there existed 59; and on December 1,
1871, this number was reduced to 47. The following
table will show the various changes that have taken
place during this period :—
‘LUNACY IN BELGIUM 231
Number of Asylums in Belgium.
glz| lag
75/2 | /ee/2/ 2
Provin a Pal e os] 2 3
rovinces A i 48 3 2B s 4s z
3 " @ 4 |38/ «2
aie? ld 8/3 a |b
| ale |8is | a] 4
+ Antwerp . ‘ . . 6} 6) 5} 5)/—/;—] 1
Brabant . . ; : 8/13 ]10]/10} 1] 1] 8
Flanders, West i ‘ 6} 7) 7] 7/—J|]—|—
Flanders, East : F 7|21)15/15] 4.) 5] 7
Hainault. : < és 4) 5); 6] 5)/—;—]—
Liégge . 2 r ‘ 4) 56} 4] 8})/—j]J—j 1
Limbourg : : : 2; 2) 2) 2;—};—]—
4, “Total . =. 2S. «| 87 | 59 | 481 47) 5 | 6 | 12-
During the first four years which followed the reor-
ganisation of asylums the population remained nearly
stationary, but in 1856 it increased in a notable pro-
portion, as will be perceived by the following table,
which shows the number of lunatics living in asylums on
December 31 each year from 1852 to 1871 inclusive :—
Sq
fan Pensioners Pauper Patients Total
gag Total
3 ga general
g wg Male | Female| Total} Male lpecadio Total | Male |Female
eha
1852 454 444 898 | 1,521 | 1,422 | 2,943 | 1,975 | 1,866 8,841
1853 493 | 582 | 1,025 | 1,527 1,502 | 3,029 | 2,020) 2,034 | 4,054
1854. 614 606 | 1,220 | 1,418 | 1,456 | 2,874 | 2,032 | 2,062 4,094
1855 608 | 628 | 1,236 |1,390| 1,448 | 2,838 | 1,998 | 2,076 4,074
1856 636 | 600 |1,236|1,501| 1,541 | 3,042 | 2,187) 2,141 | 4,278
1857 626 666 | 1,292 | 1,574 | 1,565 | 3,139 | 2,200 2,281 | 4,431
igsg | 622| 691 | 1,313 | 1,618] 1,877 | 3,195 | 2,240] 2,268 | 4,508
1859 627 750 | 1,377 | 1,678 | 1,622 | 3,300 | 2,305 2,872 | 4,677
1860 647 | 762 | 1,409 | 1,840] 1,633 | 3,473 | 2,487 | 2,395 4,882
1861 646 801 | 1,447 | 1,835 | 1,751 | 3,586 2,481 | 2,552 | 5,033
1862 681 782 | 1,463 | 1,951 | 1,756 | 3,707 | 2,632 2,538 | 5,170
i363 | 725 | 792 | 1,517 | 1,972 | 1,877 | 8,849 | 2,697 | 2,669 | 5,366
1864 701 859 | 1,560|1,939 | 1,942 8,881 | 2,640 | 2,801 5,441
1865 724 861 | 1,585 | 1,950 | 1,887 8,846 | 2,683 | 2,748 | 5,431
1866 724 | 896 | 1,620 | 2,082] 1,960 | 3,992 | 2,756 | 2,856 5,612
1867 779 | 858 | 1,637 | 2,085 | 2,069 | 4,154 | 2,864 | 2,927 5,791
1868 769 889 | 1,658 | 2,214] 2,155 | 4,369 2,983 | 3,044 | 6,027
1869 761 | 935 | 1,696] 2,349) 2,234 | 4,583 | 3,110 | 3,169 6,279
1870 772 924 | 1,696 | 2,423 | 2,843 | 4,766 3,195 | 3,267 | 6,462
1871 745 | 898 | 1,643 | 2,446] 2,392 | 4,838 | 3,191} 8,290 6,481
232 MANUAL OF LUNACY
Statistical Table from 1866 to 1870.
Number of Discharges during the ‘
insane persons ‘year Ratios per cent, upon the
d 5 5 e 8 3 8
S| 38 21a )4a/3 |B | #
¢ Bo e e 8 3 e 5 a
| 6 |e8\ 2) als gia]3/3
m 3 |a | a | & alala|/2ié
i866 | 5,404 | 1,912] 642 | 172 | 288] 592 | 8-78 | 2°35 | 3°94 | 8-09"
1867 | 5,612 | 1,865 | 627 | 140 | 268 | 656 | 8°39 | 1:87 | 3°52 | 8-77
1868 5,790 2,008 | 626] 178] 410] 557 | 8°03 | 2°28 | 5°26 | 7:14
1869 | 6,027 | 2,268 | 593 | 220 | 519 | 684} 7°15 | 2°65 | 6°26 | 8°25
1870 | 6,279 | 2,127] 596] 182 | 415 | 749 | 7°09 | 2°17) 4:94] 8-91
LUNACY IN GERMANY 233
CHAPTER XV.
ABSTRACT OF THE LAW RELATING TO PRIVATE ASYLUMS IN
GERMANY.
A ucence granted by the Minister of Police is re-
quired by all proprietors of private asylums. In order
for a patient to be admitted into a private asylum, a
medical certificate must be obtained and produced be-
fore the Minister of Police, or any person whom he may
authorise to act for him, and if it is satisfactory and
conclusive as to the patient’s mental condition, permis-
sion is granted to the proprietor to receive the patient
into his asylum. All proprietors of private asylums are
obliged to keep a “day journal” according to a pre-
scribed form, and to draw up a special statement con-
cerning each patient, and forward to the proper autho-
rities an annual report describing the condition of their
asylum.
Lunatic Asylums belonging to the German Confederation.*
a 0
a
2 ley
ax | 2S
Name of Town Description 2 @ | Be
gE |28
2 |é
a <
Aix-la-Chapelle} Annunciated Institution. . +. + «| 87 56
35 Alexianer Convent, (incurables) . .| 47 10
Allenberg .| Provincial Institution . . «© « 260 83
Bamberg . . | Local Hospital, St.Getreu. . . | 36 6
Bayreuth. .| St. Georgen Hospital . oe : | 67 10
» . . | For patients of the Jewish persuasion . 8 2
Bendorf . . | Priyate asylum of Dr. Brosius . . »| 21 15
Coblenz 3s oy Dr. Erlenmeyer . oe] 14 36
"i City Lunatic Asylum, connected rl 66 | 182
Berlin. { Gharity Hospital. 7. . .
* Report of Dr. Laehr on German Asylums.
No Asylum
can be
opened
without a
Licence.
234
MANUAL OF LUNACY
German Confederation—continued.
7
a \a
BB u
sa da fss
Name of Town Description Bo gh
a 2
a r
a le
Ay | 200 1
Munich . . | Royal District Institution . . . . | 265 | 104
Miinster . , | Connected with Clemens Hospital . . ~{ 121 5
Neu-Ruppin .| Provincial institution . a - | 157 87
Neuss < é in ‘Alexianer ‘Convent | —
” . y Connected with’ St. J cpeple Hospital . -|- _
Neu-Eberswalde] New institution ‘i a . . oe _
; $5 Private asylum . . -f[- _
Osnabriick .| Institution for 200 patients just opened 7 lll) BF —
Owinsk, Posen | Provincial hospital for 100 patients é it a —_
Pforzheim , | Institution for Grand Duchy of Baden . . | 499 93
Pfullingen . | Private asylum for 10 to 20 patients . ~loo _
Pirna . .| Private sate ‘i ow ee 12
Popelwitz . | Private asylum ee -| 382 25
Posen a . | Connected with the City Hospital 2 s | 25 17
Prag || Provincialinstitution «© + + «© + 144 | 386
Roekwinkel .| Private asylam SM atc ee
Regenburg + Institution near Regenburg (Garthans Priil) | 201 84
Roda a *| Institution for curables . » + + + | 139 54
Asylums at
Berlin.
236
MANUAL OF LUNACY
German Oonfederation—continued.
7 : = :
a \dy
- “ axa | To
Name of Town Description 3 % 3 a
§ {33
2 |4
Ay
» | 116 5
Sachsenberg .| Institutionfortheinsane . . . +{| 2383 | 91
Salzburg . -| Provincial institution . -| 39 29
{ Institution for harmless Innatics (Leprosen- } _ =
. ; ane ted ith tt, 30 pati ae be
Fe mnected with a conven’ a en ing oe Nhe
Scheibe . { weoaived « }
Schleswig .| Institution for theinsane . . . + | 639 | 109
”, »| Private asylum . . . . . . 8 1
Schmiedeberg . ay 5 20 5
Schweizerhof . a5 near Berlin for! female patients 46 36
Schwetz . :| Provincial institution | _
Sieburg . . 50 for curable patients » | 207 | 282
‘ ‘ Public institution connec! wil rince
Sigmaringen { Charles's Hospital . . . ~~ } 40 | 16
Sonnenstein .| Royal Lunatic Hospital . . . | 869 | 212
Soran. ‘| Lower Lusatian Institution for the : insane ; | 248 69
Stralsund . ane aoe ad the i a ns a = _
; unatic asylum, workhouse, an ouse 0 =
Strelitz . { correction combined . . } ee
Telgte . + | St. Rochus’s Hospital for female patients »| 31 17
St.Thomas. | Institution for the insane . . . - | 197 35
Thonberg -| Private asylum . «| & 26
Trier { Hospital, workhouse, and insane department } J cas
* combined . .
Trieste . .| Royal State Provincial Institution. . .| 136 | ~
93 i « | Connected with hospital. . . : {| 80°] —
Troppau . » | Provincial institution ‘ | 51 -
Waiblingen .| Royal Curative Institution (Winnenthal) + . | 184 97
Waigolshauser | Castle Werneck . a : . al = Sad
Wehinen. «| Institution for the insane « « «| & |
Wesel . . | City institution (“ Hohehaus ») < . | - _
Wien . «| Provincialinstitution . . . «© «| 807 | 789
” « «| Private asylum wa ey Ne es oat BR |p cat
” » 8 7 AR ate 35,560 21,324
| Blak . . . . . és 1,605 2,743
Mulatto. . . 0. ee 169 445
Chinese . . . a? Gl 35 5
Indian. . . . . 13 10 |
Total =. 37,382 24,527 |
Total of Insane and Idiots, 61,909.
Proportion of Insane to the Population.—1 in 623, or
1-06 per 1,000.
Principal Oauses of Insanity —Intemperance, grief,
physical disease, religious excitement, epilepsy.
Chief Causes of Death._—Exhaustion, epilepsy, general
paralysis, consumption.
It is not my intention to epitomise the lunacy law
of America, as each State has its own law, and to do
this would occupy @ larger amount of space than I can
now afford.
R2
MANUAL OF LUNACY
244
qyoroue” “gd “L = 2 x OL 0} 896 SPST 7 2 aRIg * + ss proouog | eatysdurey Mant
ne 9% 04 ¢ 09% 8981 * _* eyerodi0g | * * queouTA 4g | °° a
wayqdog *M *O 2 2 Agmmop 4q preg PIG 6981 Aato pus Aqunop ‘oss smog ag | °° s
seysoH HO | * * "909 $8 88z TS8T st fs most * EMossryy
mo,dun0D “FEM ws 091 SS he TD tas, AE ‘5 ss uosspee | * Iddisstsstpy
4 ee 902 998 er Brae a ‘ss goog 9g | * BqoseuUryy
UWesued uBA "AH - f z = 08 ge G08 6S8T. bi * 99899 . " * oOoZeurEley fs I DCriuclerig
4mer"aD | °° * | $0g 09 Ser OGT SIs * + eyesodioeg | - + + ofyaremog | ° i
TORIBM “VO = 08% GEST sts he | tt tt moysog | * es
oe ae 62 . . . ri . « + AMQseyMaI, . iT
- atey ‘a Me 0cF 8981 - eos ‘ + voqdureyjtoN | * =
Sappop "MM | °° * $¢07'0 08 : £0 PSB eo RCs ONS ‘s+ voymmen | * ie
sed ‘WH | * * $0149 09 StF SST egw tf _aaqssor0 | aygesnqoesseyy
a ae cS * + + egeng | + + + aptasmoyeg | -
Soqoig "H “M * ag 861 L981 * + @qerod.op qeerjey adoH ymoy | °° ee
qreMegg “WU Bo tl OR na 7 rae Pest as ee ne ‘ * * efouneg | * * pueize
OLNGH ‘WH "ot tt $204 Se ere OF8I Ba a Sep "8 8 eqsnny + ane
es 991 8781 e " f " wosyoer | * * BUBIsmOT
uemmpoyf | * ereyg ou9 Sq pred aye Sze Past eet v3 ‘ ' efasurydop | * * se
Aor "ML | * OT 04 Gog FOBT oes “ ‘ * s uoysurxeyT | * Axonqueyy
asney *O 'D 1 998T aN is * * erreyemessQ | ' * sesuBy
souuvy WM | * "sexu 4q preg S&F T98I . ee * quesvafg yomopy | * * * BMOT
SWAT ‘O a e se ce 00¢ SPST oc & *f oe syodeusrpuy * 4 euerpur
PED ‘aH + ageyg omy fq preg 09% TSS ee ree aoe ‘ * etffauosyowr | * * stounIt
weet) “TL id ae 0% GSE . “ args | * * Oraespamyy «| ** eEsIOag
pnd ‘AM “H 4 ae a1 ne ‘ewaltg | * 7 * preygmoyy | ¢ s
ous ‘TV : ie 08% 898T ‘ts ages | ts uMOVIPpHT | ° se
wpNg “Ss “L£ hs ee LST PEST * + ayerodi09 ‘8% proygre— * qnoyoeun0p
Hopjnys “Vv "ec on oe 060‘T oggt meg Se ‘5 8 mogyoog | + BrUZeETTTED
eosig 1ayeq | * "+ "9 0¢ $e 61 T981 " * 9ym9g {| * * * BsOOTBOENT, | * * BUIEqUTy
syuoyeg Jo poetedo
SyuepusyurTedng sesreyO ‘roquinyy Tou TaqowIeyO, SUMO, 509849
‘VOIMTWY 40 SHLVLS duLINQ FHL NI SWOATASV
INSANITY IN THE UNITED STATES OF AMERICA 245
SLOWDIN “DO “0
Maw ‘v
STH “
pernog "HC
Surqqngg “Ld
Tomorg "YC
Teaqooy “A “A
Japualleo “A ‘Le
dosug “d “£
Tohmeg ‘§ ‘L
uospreyory “cd °C
zynyog *g ‘sg
paay "Vv ‘£
WaALINH “Pe
u0930Tq310M “H ‘fC
ePHQyITH “DL
SMIONIMBY *O ‘pr
uopsuey "NO
Azpuny “zy
SIMOT "WL
ed “TM
WOSSELD “a
prog “D
xemoy *q *¢
3009 "D
uldeyp *Y “T
MosIeg “V “fC
SUOBIBg “TT "AY
TMOTG *T,
ude “g *c
ORTTIM “M “C
pURpALID "A ‘L
ferp "d *f£
ydjoyng “y "H
8 04 $e
‘009 $e 09 $
: es 09 $¢
squemed Aqun0p
., "B08 03 *9 09 $8
_ eS omy Aq prea
: Soe 0 $8
oxesg ong Sq pred
‘+ $9 09 $7
sso
SS8T
PS8l
998T
OL8T
881
SLLL
LE8L
T98L
OFT
G68
678T
9681
TS8L
LI8T
T¥s1
€S8T
gest
6S8T
6881
9S8T
T98I
6S8T
SS8T
SS8T
9P8T
T98T
T68T
6981
898
SPST
6781
yuouu1aA0y
" * eyes
* aqyerod109
ee ae
eo ak
99848
ayelodiog
AQID
«
“
8 BITES |
ay8.10d109
* ayes
&
8
3
oD
+ 94Rg
quersrory
S410 29 848100109
* eyeatig,
* &yanog
* oPeAltg
“ * £9
* ayecod.10p
* + 978g
TeUuyUTEto 09898;
Sane ee
oe eee ee wwe ee ee
* \ woyZurqse
+ +s gostpenr
te w0yse MA
* 9A0I1D presoq
* Toye
* BINQSUIeTITM,
> oloqeyyqerg
* uysny
oTTLAGse Ne
Biquinjop
eomaplAdlg
srqdppermd
, Aug
quoUrxT(
Sinqsurey
prioyyaelT
erqdjepengd
puepslog
AMOTASIOT
uopseg
PRUNE
snqumpop
° ysorey
yIOK AON
* kor,
enugrepueueg
° -ysnqye[a
* suyysnpT
PUBIST 8 TEMA,
orepsurmoolg
uy PLO
. uimquy
osdeayysnog
, * B00
woyuerL,
.
.
.
.
.
.
.
.
.
.
* eyquiny
“09 401481.
* UISMOOST MA
BTOISILA 959M
3 cc
* BIUTSITA
quow4a,
: * sexaz,
* + gassouuey,
euyoreg Yynog
* pussy oper
* elueaAsueg
» uode10
. 6
YIOX MON
Aosiap woNt
246
MANUAL OF LUNACY
Table illustrating the gradual Increase in Insanity.
UNITED STATES OF AMERICA, TWENTY YEARS,
Number of [Ratio per 1000
a Proportion to
Year Population Insane & Idiots} to population population
1850 23,191,876 31,397 1°35 1 in 738
1860 31,448,322 42,864 1°36 1 ,, 738
1870 38,555,983 61,909 1°60 1 ,, 623
ENGLAND, TEN YEARS.
1862 * 20,336,467 41,129 2°02 1 in 494
1865 20,990,946 45,950 2°18 1 ,, 456
1868 21,649,377 51,000 2°35 1 ,, 424
1871 22,704,108 56,755 2°49 1 ,, 400
SCOTLAND, TEN YEARS.
1862 8,083,989 6,341 2°05 - 1 in 486
1865 3,136,057 6,468 2°06 1 ,, 484
1868 8,188,125 6,931 2°17 1,, 459
1871 3,358,613 7,808 2°32 1 ,, 480
IRELAND, NINETEEN YEARS,
1851 6,552,385 15,098 2°03 1 in 484
1856 6,164,171 14,141 2°29 1 ,, 485
1861 5,798,967 16,749 2°88 1 ,, 346
1870 5,195,236 17,194 3°39 1 ,, 803
FRANCE, FIFTEEN YEARS.
1851 35,783,170 44,970 1:25 lin 795
1868 37,988,905 90,679 2°38 1 ,, 418
LUNACY IN RUSSIA 247.
CHAPTER XVII.
LUNACY IN RUSSIA.
THERE are no public records printed in Russia, contain-
ing information with reference to the state of lunacy
in that country. Hach government public asylum issues
its own report, and these are difficult to procure.
Through the courtesy and kindness of Dr. Seifert,
Conseiller d’Etat, one of the physicians of the Imperial
Asylum at St. Petersburg, I have obtained the follow-
ing information. Hach city has its own public asylum
for the admission of private as well as pauper patients.
There are two classes—Ilst, Placement voluntaire, these
are called private patients. 2nd, Public or govern-
ment patients. The first class or private patients are
admitted on the order of a relative and one medical
certificate. The second class or government patients
are sent by the police, no medical certificate on admis-
sion being necessary. The police require the patient to
be examined by their own medical man previously to his
being sent to the asylum, but this certificate is not pre-
sented at the asylum when he is admitted. After the
reception of the patient, the medical officers of the asy-
lum write to the police authorities for the details of the
case, and for the certificate drawn up by their own medi-
cal officer. A return is made relative to the mental state
of the patient to the chief governor of St. Petersburg.
In the course of the second, third, or sixth week the
governor issues a command for the patient to be brought
before him, in order that he may be examined by a
248 MANUVAL OF LUNACY
medical man appointed by himself. If owing to illness
or any other cause, this command cannot be complied
with, the governor, accompanied by his own medical
adviser, visits the asylum and examines the patient.
When restored to health the patient returns to his rela-
tives. Nothing is paid for the maintenance of pauper
patients in an asylum, everything, including clothes
and linen, are provided gratuitously for them. In the
high class private asylums of Russia the expense of
maintenance ranges from 201. per month to a higher
sum. There are three private asylums in St. Peters--
burg, the Imperial Asylum of that city contains 400
patients, and has four resident medical officers—viz.,
Dr. Lawrence, the chief physitian, Dr. Herzog, Dr.
Sheman, and Dr. Seifert. These physicians have sepa-
rate suites of rooms allotted to them, but no private
residences. They have fixed salaries, and, with the
exception of lodgings, lights, and firing, they have to
provide for themselves. As compared to what .the
English resident medical officers receive, the pay of the
Russian physician is very small, but they are not like
the English medical men, who are the resident medical
officers of public asylums, debarred from practice. The
usual fee in cases of lunacy is never less than three
guineas, sometimes much higher fees are received.
RECENT LUNACY STATISTICS AND INSTRUCTIONS 249
CHAPTER XVIII.
RECENT LUNACY STATISTICS AND INSTRUCTIONS.
Since the preceding portion of the volume has been
sent to press, the Annual Report of the Commissioners
in Lunacy for 1873 has been issued; and, with a view of
placing before the reader the most recent information
relative to the subject of lunacy, I append the following
particulars :—
Statistics of Insanity, Jan. 1, 1873.
The following summary shows gererally the classifi-
cation and distribution of the patients registered on
Jan. 1, 1873 :—
Private Pauper Total
M.; FL] T. |) M. F Te M. RF, Tv.
In County and
. Borough Asylums| 183) 196) 879/13,799/16,295)/30,094 13,982/16,491/30,473
In Registered Hos- :
nite 7 . |1,213}1,084]2,297] 191) 160) 3851] 1,404] 1,244) 2,648
In LicensedHouses |1,734/1,516|3,250| 405] 838) 1,243) 2,139) 2,354 4,493
In Naval and Mili-
tary Hospitals,
and Royal India i
Asylum . . | 323) 15) 338) — _ — 823) 15} 338
In State Criminal
sr Agel a . | 272} 64) 336) 134 38) 172 406 102} 508
ivate Single Pa-
a He < 170} 253) 423) — _— _ 170) 253) 423
In Workhouses —| —| — | 6,209} 8,184/14,343] 6,209) 8,134/14,343
Out-door Paupers; — | —] — 2,839] 4,231) 7,070 2,839] 4,231] 7,070
Total . _ « {3,895/3,128]7,023|23,577|29,696/58,273 /27,472|32,824 60,296
These numbers do not include 188 persons found
250 MANUAL OF LUNACY
lunatics by inquisition. There is an increase of 1,656
upon the number returned on January 1, 1872.
Ratio per 1,000 to
Year Population Lunatics on Jan, 1, 1873 Population
2°58
1873 23,356,414 60,296
New Asylum for Middlesex.
A new asylum, in conformity with the suggestions
of the Commissioners in Lunacy, for the county of
Middlesex is to be opened at Banstead, in the county of
Surrey.
An estate of about one hundred acres has been
purchased at a cost of 10,0001.
The Asylum will probably be fit for occupation at
the end of 1875.
There are at present 725 patients belonging to the
county of Middlesex for whom no provision has been
made by the county.
THIRD ASYLUM FOR MIDDLESEX.*+
Instructions to Architect, issued by the Committee of
‘ Justices.
1. The general plan of the Metropolitan District
Asylum at Leavesden is to be followed.
2. Provision is to be made for 580 male patients, of
whom 100 are to be in an infirmary, consisting of 3
dormitories for 30 beds each, with 10 single rooms, and
the remaining 480 in 3 blocks. Each block to consist
of a day-room on the ground floor, 14 feet high, and 2
dormitories on the first and second floors, each contain-
ing 70 beds, with 20 single rooms. Store rooms,
‘sculleries, padded rooms, and attendants’ rooms to be
provided in each block.
3. Provision is to be made for 1,020 females, of
* Appendix E, Commissioners’ Report, 1873.
RECENT LUNACY STATISTICS AND INSTRUCTIONS 251
whom 100 are to be in an infirmary, 800 in 5 ordinary
blocks, and 120 in a block of like construction, but
connected with the laundry. Single rooms, sculleries,
padded rooms, and attendants’ rooms to be provided as
on the male side.
4. Provision will have to be made for the following
staff :—
Two medical superintendents, who will be married’
men, and must be provided with separate houses and all
necessary offices, but connected with the main buildings,
one with the male side, and the other with the female
side. -
Two assistant medical men, and for whom apart-
ments without offices will be sufficient.
One matron in apartments, with accommodation for
a servant, kitchen, &c., in connection with the female
side.
One steward, a married man, who will require a
separate house.
One workmistress, who will require a separate
sitting-room and bedroom.
One laundry matron, the like.
The superior male attendants, one sitting-room in
common, and a bedroom apiece.
Two female ditto the like.
Thirty-two male attendants, of whom 6 must sleep
in the infirmary, 4 in each block, and the rest where
they can be most conveniently placed.
Fifty-eight female attendants, of whom 6 must sleep
in the infirmary, 10 in the laundry ward, 4 in each block
on the female side, and the remaining 22 where they
can be most conveniently placed.
Defective Certificates. Instructions by Commissioners.
The Commissioners, in their Report, draw special-
attention to the various defects in medical certificates
Private
patients:
Instruc-
tions.
252 MANUAL OF LUNACY
in consequence of carelessness on the part of those
signing. Last year, out of 12,176 notices of admission
sent to the office, 2,314 were returned for amendment,
The Commissioners, with the view -of assisting the
proper filling-up of the statutory forms, have drawn up
a paper of instructions in Appendix P of their Report
just issued. .
LUNACY.*
Private Patients.
In order to justify the charge or detention of a
lunatic (which expression includes an idiot and a person
of unsound mind) as a private (7.¢., not pauper) patient
in a county or borough asylum, hospital, or licensed
house, or as a single patient ¢ elsewhere (except where
no payment is made for, or profit derived from, the
charge, or where a committee has been appointed by
the Lord Chancellor), the law requires,—
1. An order of reception, signed by some person,
“requesting the superintendent or proprietor of the
asylum, hospital, or house, or the person who is to take
charge, to receive the patient.
2. Two certificates, each signed by a registered
medical practitioner, stating that he~-has separately
examined the patient, and on such examination found
him to be of unsound mind.
INSTRUCTIONS AS TO ORDER AND CERTIFICATES.
It being unlawful to receive or take charge of a
lunatic, except as above, without these documents, it
follows that both the order and the certificates must be
signed before the reception takes place, and must bear
* Appendix P. Report, 1873. ;
f No-licence is necessary where merely one insane patient ata
time is received. Such one patient is called a “ single patient.”
RECENT LUNACY STATISTICS AND INSTRUCTIONS 253
date either on or before, but not after, the day of such
reception or of first taking charge. The order may be
signed before or after the certificates, or either of them.
Two blank forms (duplicates) of order and accom-
panying statement of particulars and certificates, if not
sent herewith, must be procured.* These forms are
statutory (Acts 16 & 17 Vict. c. 96, Schedules A. and
C.; ¢. 97, Schedule F., Nos. 2, 3, 4), and must be strictly
adhered to.
One of these forms must be completed as an original,
by the person giving the order and by the two certifying
medical men. On the reception of the patient, this
original document is to be given to the proprietor,
superintendent, or person receiving or taking the charge,
and must be carefully preserved by him, being his sole
authority for detaining the patient.
The second blank form is for the use of the pro-
prietor, resident superintendent, or person taking
charge, who is bound by law to make and transmit
exact copies of the original order, statement, and cer-
tificates to the Commissioners in Lunacy.| He must
fill up and sign the notice of admission, which is on the
first page of the form, and, within one clear day from
the day of reception, post the copies and notice,
addressed— ;
‘Tur SECRETARY,
Office of the Commissioners in Lunacy,
19, Whitehall Place, London, 8.W.
* These forms, and others presertbed by the Lunaey Acts, are
kept in stock by Messrs. Shaw and Sons, Fetter Lane, and Messrs.
Knight and Co., 90 Fleet Street, London, E.C.
+ From houses licensed by justices, copies and notice must ge
to the Clerk of the Visitors.
Private
patients.
Instruc-
tions.
Private ~
patients,
Instruc-
tions,
254 MANUAL OF LUNACY
STATEMENT OF CONDITION.
After two clear days, and before the expiration of
seven clear days, from the day of reception, the patierit
must again be examined, and a statement of his mental
and bodily health as observed at the time of examina.
tion must be transmitted to the Commissioners in
Lunacy.*
This document, which must be in the statutory form,
must be signed—
(a.) In the case of an asylum, hospital, or licensed
house, by the medical officer, medical superintendent,
proprietor, or attendant :
(b.) In the case of a “single patient,” by the
“medical attendant’? appointed by the friends of the
patient. He must be a registered medical practitioner,
who did not sign either of the certificates of insanity, or
the order for reception, and who derives no profit from.
the care or charge of the patient, and who is not a
partner, father, son, or brother of any person deriving
profit from such care or charge.
AMENDMENT OF Derective ORDERS AND CERTIFICATES.
If requiring and capable of amendment, the original
order or certificates may be amended, with the sanction
of the Commissioners, within fourteen days next after
the reception. In such a case instructions will be sent
as to the amendnients required in the originals, and
the copies will be returned for precisely. corresponding
alterations. No corrections or amendments in the
original order or certificates are to be made by anyone
except the person who signed the defective document,
and he should affix his initials opposite to each altera-
tion.
* And to the Clerk of the Visitors, where the house is licensed
by Justices.
RECENT LUNACY STATISTICS AND INSTRUCTIONS 255
MepicaL Examination.
The patient must not be medically examined in the
house where he is to remain, nor on the premises.
Should he have been living in the house previously to
legalising the charge, the date of admission given in the
notice of admission should be that of the day whereon
he returns to the house after signature of the order,
medical examinations, and signature of the certificates.
Should it become necessary to obtain fresh certificates
the patient should, as above, be removed for examination.
In this case, and where a fresh order has been required,
a fresh notice of admission must be transmitted.
Certificates signed, or founded on medical examina-
tions made, elsewhere than in England or Wales (the
extent of the Commissioners’ jurisdiction), are not
accepted as a valid authority for the detention of a
patient within that jurisdiction.
Cautions.
1. No order is valid unless the person signing it has
seen the patient within one month previous to the date
of the order.
2, An order becomes invalid and useless if the
reception does not take place within one month from
the date of the order.
3. No certificate is valid if signed—
(a.) By a non-registered practitioner ;
(b.) By the partner or assistant of the person
signing the other certificate ;
(c.) By the person who signs the order, or by his
father, brother, son, partner, or assistant,
4. A certificate becomes invalid and useless if the
reception does not take place within seven clear days
from the date of the medical examination on which the
certificate is grounded.
Private
patients.
Instruc-
tions.
Private
patients.
Instruc-
tions.
256 MANUAL OF LUNACY
5. For reception into a county or borough asylum no
certificate is valid which is signed by any medical officer
of the asylum in question.
6. For reception into a licensed house or hospital no
certificate is valid which is signed by—
(a.) A medical man, who is- wholly or partly ihe
proprietor of, or a regular professional attendant in, such
licensed house or hospital ; nor by
(b.) The father, brother, son, partner, or assistant
of such last-mentioned persons, or of either of them.
?. For reception into a licensed house no certificate
and no order is valid which is signed by—
(a.) Any person receiving any percentage on, or
othérwise interested in, the payments on account of any
patient received into the house in question ;
(b.) Any medical man keeping, or in his medical
capacity attending, such licensed house.
8. For reception of a ‘single patient’? imto a private
house no certificate and no order is valid which is signed
by the person who takes the charge, or who receives a
percentage on, or is otherwise interested in, the pay-
ments for the patient.
N.B.—The person who is intended to act as the
regular medical attendant will be precluded from so
acting if he signs either order or certificate.
9. No medical man can receive a “ single patient”
into his house on a certificate signed by himself, or by
his father, brother, son, partner, or assistant.
Cuartes SPENCER PERcEVAL, Secretary.
Office of the Commissioners in Lunacy.
Ohanges im the Commission.
Mr. John Forster, who has filled the office of one of
the Visiting Commissioners in Lunacy for a period of
five years, has, in consequence of ill health, resigned his
RECENT LUNACY STATISTICS AND INSTRUCTIONS 257
post. His great experience and knowledge will still be
available to the Board, as he will act as one of the
Honorary Commissioners. Mr. Charles Palmer Phillips
succeeded Mr. John Forster as ‘Commissioner, and Mr.
Charles Spencer Perceval succeeded to the Secretary-
ship of the Commission, vacated by Mr. Phillips. Mr.
Lutwidge, who for many years was connected with
the Commission, I regret to say, during a visit paid by
him in conjunction with Mr. Wilkes a few months since »
to Fisherton House lunatic asylum, Salisbury, was ;
murderously attacked by a patient, and killed. It is
a matter of great regret that the Board has been de-
prived of the valuable services of one of its oldest mem-
bers. Mr. Lutwidge was always ready and willing to say
a kind word to all the patients during his official visita-
tions, and his sympathy, consideration, and kindness
were conspicuous. The Hon. Greville Howard has been
appointed by the Lord Chancellor as a successor to Mr.
Lutwidge. Col. Clifford retired from the Honorary
Board of Commissioners during the year.
Patients in Asylums.
The asylums, hospitals, and licensed houses visited
by the Commissioners during the year amounted to 182.
The average daily number resident in asylums during
the year is 30,302. The percentage of recoveries on
the admission for the past: year was 38°34—being more
favourable than in any year since 1862. The percentage
of deaths upon the number of insane persons treated
was 7°53, the rate of mortality being lower than in any
year since 1858.
The number of persons of unsound mind confined
in county and borough asylums on January 1 was
30,473; out of which number only 2,476, or 8-12 per
cent., were deemed as curable cases.
The number of patients admitted into asylums,
8
258 MANUAL OF LUNACY
hospitals, and licensed houses during 1872"was 12,016,
Of this number 1,356 were transfers from other in-
stitutions. If this number is deducted from the total
number of admissions,-the admissions will amount to
10,660, or 90 more than in 1871,
Private Asylums. Remarks by Commissioners,
Ticenies “In the houses licensed for the reception of the
, Insane we continue to observe a general improvement.
As may easily be understood, the houses themselves
vary in their style of building, in the character of their
management, and in the degree of accommodation which
they afford. However frequently the houses may be
imspected by ourselves or by the Visitors, the amount of
comfort enjoyed by the patients, and the provision for
the proper treatment of their malady, must still to a
great extent depend upon the special aptitude of the
resident licensee for his post, upon the ability and will-
ingness of the proprietor to incur liberal outlay, and
upon the numerical strength and efficiency of the staff
of attendants employed by him.
“Thus, in the proprietary establishments of the best
class, where the scale of payment is high, a correspond.
ing amount of comfort is enjoyed by the patients. In
some instances, individual patients occupy well-furnished
villas in the pleasure-grounds detached from the prin-
cipal building. They are attended by their own servants,
make use of their own equipages, and, indeed, are
debarred from tio enjoyments, however Juxurious, which
are compatible with their own welfare and not liable to
endanger other persons. Others of less affluence jointly
occupy the main building. Usually, in houses of this
’ class, each person has his separate bedroom, and, where
his means justify it, his private sitting-room. But in
those establishments where the rate of payment is more
moderate, the patients, classified according to their
RECENT LUNACY STATISTICS AND INSTRUCTIONS 259
mental condition, occupy associated dormitories and
day-rooms. .
“For a long time both out-door exercises and in-
door occupation have been encouraged more or less
in all licensed houses. Such of the patients as can be
trusted not to abuse these privileges enjoy a considerable
amount of freedom, many being even permitted to ex-
tend their walks beyond the grounds unattended. The
airing-courts, formerly bare gravel yards, are now
changed for pleasant gardens, containing conservatories
for the supply of flowers for the decoration of the in-
terior of the house.
“Tn the treatment of the insane, much depends cn
sufficient means of amusement and employment ; and it
is gratifying to us to be able to report that this fact
appears at the present day to be freely admitted by the
proprietors of licensed houses both in town and in the
country. In most of them, daily gatherings of the
patients take place at family prayers, at meal times, and
for out-door games. The inmates are also periodically
assembled for dramatic and musical entertainments.
-“ Our aim kas always been, and still is, to take from
these houses, as far as practicable, the appearance of
mere receptacles for the insane, to do away with all un-
necessary mechanical contrivances for security, and to
assimilate their arrangements to those of a well-regulated
boarding-house or family residence. To a certain extent
we have been successful. The sexes are now in many
licensed houses brought into more frequent association,
to their mutual advantage. The patients’ relatives are
occasionally induced to become boarders for days, and
even weeks, and so to alleviate the distress incident to
compulsory residence within an asylum; lady com-
panions are also provided to amuse female patients of
the first class; and trips to the sea-side break the
monotony of routine life. Reading, drawing, music, and
82
Licensed
houses.
Licensed
houses.
260 MANUAL OF LUNACY
needlework are among the amusements of the ladies,
and for the gentlemen’s recreation, books and news-
papers, and billiard tables, continue to be supplied.
“In fact, licensed houses are at the present day
very different institutions from what they were within
the memory of many members of our Board, and the
difference would, we believe, astonish those who only
remember the old state of things, and have not watched
the gradual alteration since this Commission was first
appointed. The defects which remain are chiefly those
inherent in establishments kept for profit; and it is
therefore, we think, of the first importance that the
selection of the licensees should be carefully considered.
We fear that in some instances the grants of licences by
the Courts of Quarter Sessions have been rather too
much matters of course; but in that direction, also, we
observe gradual amendment. ,
“There is yet, beyond question, great room for im-
provement in the description of attendants employed in
licensed houses. They should always be selected from a
very superior grade, and we frequently remind licensees
that such ean only be attracted by good wages. It
must, however, be borne in mind, that patients are in
some houses received at too low a scale of payment to
admit of a high rate of remuneration for those who take
personal charge of them, or, indeed, of much outlay in
other directions.”
Remarks of the Commissioners on Seclusion.
‘Without questioning the utility of seclusion in cer-
tain cases of excitement, especially amongst epileptics,
we think that in a remedial point of view its value has
been much exaggerated, and that in many instances it
is employed unnecessarily and to an injurious extent, and
for periods which are quite unjustifiable.
“By patients themselves seclusion is no doubt
RECENT LUNACY STATISTICS AND INSTRUCTIONS 261
usually regarded as a punishment, and besides being scene
most objectionable on this ground, it is too often re- ,
sorted to in cases of temporary excitement, which might
be readily subdued by treatment of a less repressive
character. Upon the attendants themselves also its
frequent use has a most injurious effect, by leading
them improperly to seek through its means relief from
the duties jand responsibilities involved in a constant
and vigilant supervision of those placed under their
charge. 7 a
“The frequent resort to seclusion in the treatment
of the insane we can only attribute in most cases to
defective organisation or management of the asylums,
more especially as regards an adequate staff of properly-
trained and diligently-supervised attendants, and we
think that in all such instances persevering efforts
should be made by improved arrangements to diminish
its employment, and keep it within the narrowest pos-
sible limits.”
Single Patients. Remarks of Commissioners in Lunacy.
“The following tabular statement shows the num- Single
bers of Single Private Patients subject to our jurisdiction P*4e™*
and visitation, as they existed at the commencement and
termination, respectively, of the year 1872, and the
changes in the same which took place during that
year :—
; — Males | Females | Total
Numbers, January 1,1872 . . . ‘ » | 168 252 420
et Registered during the year. ‘ Fé . a 60 100 1€0
| Discharged and removed . . < é * . 47 87 184
rh of whom recovered . . . . 8 10 18
Died. . BG a ae . 11 12 23
Remaining January 1 last a a . ‘ «| 170 253 423
“In accordance with the resolution referred to in
Single
patients.
262 MANUAL OF LUNACY
our Seventeenth Report, which had received the ex-
press approval of the Lord Chancellor, we have, ever
since the passing of the ‘ Lunacy Regulation Act, 1862,’
diseontinued visiting single patients found lunatie by
inquisition, as rendered quite unnecessary by the 20th
section. Of the single patients on January 1 last, 118,
viz., 55 of the male and 68 of the female sex, came-
within the class of lunatics under commission, leaving,
as patients to be regularly visited by us, 305, viz., 115
of the male and 190 of the female sex. :
“ During the last ten years the single patients regu-
-larly visited by us have trebled in number. At the
commencement of that period the total number of
single patients was only 150, of whom very nearly one-
third were found Innatic by inquisition.
“The accessions from time to time have no doubt
been in great measure attributable to the prosecutions
instituted by our Board for illegal reception of patients
without certificates,.to the wider promulgation of the
law by these criminal proceedings, and to the circulars
and papers of instructions published and generally
disseminated by us with that view.
“Tn illustration of this statement we may refer
specially to the fact, that towards the end of the year
1864, pending the prosecution (adverted to in our
Nineteenth Report) of a medical man, as many as 16
notifications were received by us from parties haying
charge of uncertified patients, with requests to be
furnished with such forms and papers as would then
enable the applicants to comply with all the statutory
requirements. After the conviction of this person, who
was fined 501, and before the end of the same year, a
period of less than three months, no less than 37 fresh
returns were made to this office.
“We continue to receive frequent voluntary com-
munications from medical men and others, disclosing
RECENT LUNACY STATISTICS AND INSTRUCTIONS 263
their reception of insane persons, or persons of ques-
tionable sanity, placed under their charge by relatives.
In such cases generally, we are satisfied by immediate
and due compliance with the statutory requirements.
“The results of inquiry and correspondence, and the
information collected by us in the course of official
circuits, satisfy us that there are throughout the country
a considerable number of Insane persons who are not,
but ought to be, placed under orders and medical cer-
tificates as single patients. In many instances, no
doubt, ignorance of the law applicable to such cases
might fairly be pleaded by non-professional persons, but
we cannot admit such a plea on the part of medical
men, who assuredly ought to be aware of the provisions
of the Acts relative to lunatics, idiots, and persons of
unsound mind,
“There are other reasons for concealment and
non-compliance with the law which, we have reason to
think, mainly actuate parties thereto. We refer, amongst
‘others, to a reluctance on the part of relatives, by dis-
closing the circumstances, to brand the family with the
taint of insanity. In this point of view, they object to
submitting the patients to our jurisdiction and visitation.
When influenced by such considerations, the parties are
possibly not aware, or fail to bear in mind, that every’
one in this department is sworn to secrecy, and, conse-
quently, that publicity through the medium of our
office is out of the question.
“ Another actuating motive for evading the fulfil-
ment of the provisions of the Lunacy Acts is, we cannot
doubt, a fear of inquiry into the sources, amount, and
administration of the patient’s property and available
income, a subject which we invariably investigate.
“Tn our Fourteenth Report we stated at length our
general views on the subject of single patients, their
care and treatment, the payments made for them, the
Single
patients.
264 MANUAL OF LUNACY
staat question of management and application of their pro-
patients, erty, and the mental state of those who had come
under our notice.
“In order that single patients may have all the
benefit of medical care and treatment intended by the
Legislature, we, as a rule, even where the patient is
residing under the charge of a professional man (phy-
sician or surgeon), decline to sanction any dispensation
of the statutory medical fortnightly visits, until the
Board shall have received a report of a visit to the
patient by one of their number.
“The visits which, as a rule, we make annually to
patients of this class, now upwards of 800 in number,
necessarily entail a great expenditure of time,. money,
and labour. These patients are scattered over all parts
of England and Wales, and frequently reside in remote
country districts, many miles distant from railway
stations. In fact, the visit to one patient in some cases
occupies an entire day, and, of course, involves propor-
tionate travelling and personal expenses.”
Regulations respecting Detention of the Insane in Work-
houses.
“ Local Government Board, Whitehall, 8.W.,
’ “ August 10, 1872.
_ Circular “ Sir,—The Local Government Board are informed
canes by the Commissioners in Lunacy that, in the course of
plore their periodical visits to workhouses, they have had
occasion to notice that the provision in Section 20 of
the Lunacy Amendment Act, 1862, 25 & 26 Vict. c. 111,
so far as it imposes a duty on the medical officer, is very
imperfectly observed.
“ The former part of that section is as follows: ‘No
person shall be detained in any workhouse, being a
lunatic or alleged lunatic, beyond the period of 14 days,
unless, in the opinion given in writing of the medical
RECENT LUNACY STATISTICS AND INSTRUCTIONS 265
officer of the union or parish to which the workhouse
belongs, such person is a proper person to be kept in a
workhouse, nor unless the accommodation in the work-
house is sufficient for his reception; and any person
detained in a workhouse in contravention of this sec-
tion, shall be deemed to be a proper person to be
sent to an asylum within the meaning of Section 67
of the Lunacy Act, cap. 97.2 (See 16 & 17 Vict.
c. 97.)
“In order, therefore, to justify the detention in a
workhouse, beyond the above-mentioned period of 14
days, of any lunatic or alleged lunatic, it is in strictness
necessary that the medical officer of the workhouse
should certify in writing that such person may properly
be kept there. The statute, it will be seen, imposes the
further condition, that the accommodation in the work-
house shall be sufficient for the reception of the lunatic
or person of unsound mind.
“In the event of this important provision having
been overlooked in your union, I am directed by the
Board to request that the guardians will at once call
_the attention of the medical officer to the omission, in
order that the law in this respect may be strictly com-
plied with in future.
“The certificates given from time to time by the
medical officer should be preserved by the master of the
workhouse, and laid before the Visiting Commissioner
in Lunacy, with the book or list of insane inmates re-
quired to be kept by Section 87 of the Act 25 & 26
Vict. c. 111, above referred to.
“JT am, Sir, your obedient servant,
“HH, FLEMING,
“ Secretary.
«To the Clerk to the Guardians.”
Cireular™
from Local
Government
Boar
266
MANUAL OF LUNACY
Statistics of Insanity in all Countries.
In arranging the Statistical Tables I have derived
great assistance from the Report of Dr. Williams, Cons
missioner in Lunacy for California, published Decembey
1871. It is a most valuable and interesting compilation
of facts relating to the insane.
Tables, I have copied from his Report: they show the
condition of the insane in various parts of the world.
The two following
Table I.
Census Ratio to
Countries | taken oe Bepalee Males |Females| Total | Popula- |’.
oncein| ° uO tion
Treland . 10 years| 1861 | 5,798,967 | 3,500} 3,565 | 7,065 |1 in 821
Sngland and = vases
Wales «| ,, 5: | 1861 |20,066,224 | 11,249 | 13,096 [24,345 | ,, 824
Newfonnd- p
land . ala iss 1857 | 122,638 50 38 88} ,, 1,394)"
Nova Scotia |,, 4, | 1861 | 3830,857/ 166] 174] 840] , 973] °
Prince Ed-
ward'sIsld. | 7 4, 1861 80,857}. «|. -| 148] ,, | 546
United States [10 ,, | 1860 [31,445,080]. .|. . |28,999] ,, 1,810)
France. .|6 4, | 1856 |36,012,669}. . . (35,031 | ,, 1,028
Savoy . ./4 4, | 1861 | 542,535| 143 167 | 310} ,, 1,750
Belgium .|10 ,, | 1856 | 4,529,560 | 2,019 | 1,998 | 4,017] ;, 1,128
(Holland .|,, 4, | 1859 | 8,308,969] 1,088] 1,101 | 2,139| ,, 1,647
Hanover eis Fy 1861 | 1,888,048 | 1,591 | 1,493 | 3,084 | ,, 612)
Prussia. .|,, 4, | 1858 |17,739,913|/. ./. «|. -|. O°
Saxony. elo 9 1861 | 2,225,240). .]. - | 1,659 | ,, 1,427
Bavaria a ee 1861 | 4,689,837 | 2,576 | 2,323 | 4,899 | ,, 957]
Wurtemburg |,, ,, | 1861 | 1,720,708| . 690] 648 | 1,338 | ,, 1,286
Hegse Darm-
stadt. .|,, 4, | 1861| 856,907/. . wile will) ee. $e
Oldenburg .|. 1855 287,163 446 508 954 | ,, 301
Denmark .|5 ,; | 1860 | 2,605,024] 2,543] 9,692 | 5,135 | ,, 507
Sweden. .|,, 5, | 1855 | 3,641,011| 1,898] 1,995 | 3,893] ,, 985]
Norway .(|1C ,, | 1855] 1,490,047) 619] 710 | 1,329 | ,, 1,121
Piedmont ./10 ,, 1858 | 5,041,853]. «|. . | 1,750] ,, 2,881
Italy . oles . 1867 |24,263,320}. .|. «| 8,191 | ,, 2,962]
Austria. .{|. «| 1864 /13,000,000/., ./. .| 38,215] ,, 4,048
(New South ‘
Wales el «| 1867 447,620/. .|. 11,156] ,, _ 387]
California .|. | 1870 60,2471. . |. . | 1,283] ,, 1,454
RECENT LUNACY STATISTICS AND INSTRUCTIONS 267
Table IT.
Number of oo
Insane and Proportion
; Tdiots of Insane
Countries a Population. Total and
pH Idiots to
Insane | Idiots Population
United States .| 1870 | 88,555,983 | 87,382 | 24,527| 61,909 | 1 in 623
England . .| 1870) 22,090,163]. .|. .| 54,713 | ,, 403
Scotland . .|1870| 93,222,887/. .|. .| 9,571] 4, 336
Ireland « . .|1860| 5,195,236 | 11,122 | 6,072| 17,194 | ,, 302
France . « | 1866 37,988,905 | 50,726 | 39,953] 90,679 » 418
Prussia . « | 1867 23,971,337 | 16,929 | 21,031] 37,960 » 631
Belgium . .| 1865] 4,984,451 7,431 | 4, 671
Total. . 136,008,912 | — — | 279,457 | 1 in 486
Varieties of
insanity.
268
DEFINITIONS AND EXPLANATION OF TERMS GENERALLY
USED TO DENOTE VARIOUS FORMS OF INSANITY.
I po not propose to enter minutely into this subject,
My object is, as far as practicable, to briefly define
those types of mental derangement which medical men
may be called upon to describe when certifying as to
a patient’s mental unsoundness prior to legal confine-
ment, or when giving evidence in courts of law relative
to cases of criminal insanity or disputed testamentary
MANUAL OF LUNACY
CHAPTER XIX.
capacity.
The principal terms used to denote various forms of
insanity are as follows :—
Mania ; acute, chronic, and recurrent.
. Monomania.
. Melancholia ; acute and chronic.
Dementia; acute, and chronic.
. Imbecility.
Idiocy.
Nymphomania.
. Kleptomania.
. Delusions ; hallucinations, and illusions.
. Delirium.
. Dipsomania.
. Homicidal and moral insanity.
. Puerperal insanity.
. General paralysis of the insane.
ACUTE MANIA 269
Acure Mayta is usually defined to be an active dis-
order of the brain, affecting the propensities and all the
operations of thought. It is generally associated with
symptoms of bodily disease and indications of active
mischief going on in the brain, such as congestion of the
cerebral vessels or inflammation of the brain itself and
its membranes (meningitis and cerebritis). In this form
of insanity delusions of a painful character crop up; the
conversation is generally wild and incoherent; the
patient is morbidly suspicious, often fancying that he has
been or is about-to be poisoned. Under the effect of
these delusions he often becomes violent—furiously
so—and occasionally tries either to injure himself or
others. Sleeplessness (insomnia) and excessive garrulity
are among the prominent and earliest symptoms of an
attack of acute mania. The mind is in a state of intense
morbid exaltation, the judgment, will,: and in fact all
the faculties of the mind are perverted, and the patient
is in a constant state of physical restlessness, often un-
conscious of the calls of nature, and eventually becomes
filthy in his habits and conversation. There are, in
cases of acute mania, a great variety of symptoms
ranging from extreme violence to milder manifestations
of the disease. ;
In Curonic Manta the symptoms are less acute, de-
lusions, however, generally exist, the perceptions are
disordered, and the conversation incoherent.
Recurrent Manua.—This is a variety of insanity
often met with. The patient, after labouring under an
attack of mania for a variable period, suddenly becomes
for a certain’ time, apparently of sound mind and
appears to be free from all delusions. He continues
well for perhaps a month or even longer, and then
will have another attack, which will pass off, to be
followed again by apparent restoration of the mental
faculties. The interval between the attacks of mania is
Characteris-
tics of acute
mania.
Recurrent
mania.
Dr. Prit-
chard on
crime com-
mitted dur-
ing a lucid
interval.
Monomania,
Delusions
frequently
met with in
monomania,
270: MANUAL OF LUNACY
called a lucid interval. Jord Coke describes a patient
who is suffering from recurrent insanity as “a lunatic
that hath sometimes his understanding and sometimes
not.” “ Aliquando gaudet lucidis intervallis, and there-
fore he is called non compos mentis so long as he hath not
understanding.”
It is curious to observe a person who for one month
is quite insane, the next apparently recovered. Lucid
intervals occur in patients who have been insane for
many years. :
Dr. Pritchard says “that no person should be con-
victed for a crime committed during a lucid interval,
because there is a probability that at the time of the
offence he might have been under the influence of that
degree of cerebral irritation that renders a man insane,”
A will made by a patient during a lucid interval is
valid.*
Mownomania is a form of insanity associated with
some prominent delusion, often confined to one idea, .
the patient being apparently sane on. all other points.
It is a vexed question whether it is possible for the
mind to be deranged on one subject only. Cases of
pure monomania are certainly of rare occurrence, for
even in patients who appear to be monomaniacs the
mind, if carefully analysed, will be found to be under
the influence of several delusions. The principal mor-
bid ideas met with in the “ monomaniac” are as
follows :—
1. That a conspiracy exists against him.
2. That his food is poisoned.
3. That he has been guilty of some great crime, and
under this delusion he will often wish to deliver him-
self up to the police or public magistrate.
* Two forms of lucid interval are spoken of, one in which there
is an apparent suspension of the disease, and the other in which
there is a temporary suspension of its manifestation.
MELANCHOLIA 271
4, That he is addressed by strange and imaginary
voices (auricular delirium) ; a most unfavourable form
of monomania,
5. That he has committed the unpardonable sin, is
forsaken of God, and out of the pale of salvation.
6. That he is Jesus Christ.
7. That he is a king, or some great person; under
this delusion he will comport himself accordingly.
8. That he has at his command great wealth.
9. That he is ruined and on the eve of bankruptcy.
The monomaniac is unable to talk rationally upon the
subject connected with his particular delusion, but in
all other respects he appears perfectly sane. Beyond
this no unsoundness of mind is perceived. Pritchard
says that “the mind in monomania is unsound, not un-
sound in one point only and sound in other respects, but
this unsoundness manifests itself principally with re-
ference to some particular object or person.”’
MELANCHOLIA, acute and chronic.—This affection is
indicated by a state of profound mental depression, often
associated with suicidal ideas and delusions on religious
and other subjects. These patients often refuse their
food, and are obliged to be fed by mechanical means.
The mind is often occupied in the contemplation of one
or more prominent, delusions, and the unhappy man
will sit for hours together moping and gloomy in the
corner of the room, apparently unconscious of what is
going on. This acute state of melancholia often lapses
into Curonic MetancHouia. In this form of mental dis-
order the symptoms are generally similar to the type
previously described, but are less acutely manifested.
It may be defined as a condition of mental depression
generally associated with some delusion or hallucination.
In some cases the physical health is but slightly de-
ranged. The liver and digestive organs however are
often found to be in a disordered state, hence the term
Dr. Prit-
chard on
monomania.
,
Characteris-
tics of
melan-
cholia.
272 MANDAL OF LUNACY.
melancholia is derived from a Greek word signifying
“black bile.” * The delusions of these patients are often
of a religious character, the patient believing that he
has committed the unpardonable sin, sin against the
Holy Ghost, or that he is doomed to eternal punishment,
having no hope of salvation.
Warieties of Melancholia assumes various forms, viz., melancholia
fMetancno. concentrica, in which the fancies relate to the internal
sensations of the patient; and melancholia which is
confined to external objects, and is called melancholia
peripherica, There are also melancholia religiosa, de-
monia, and attonita. These acute forms of melancholia are
often preceded by severe attacks of profound hypochon-
driasis. This latter state of mind is accurately described
by the poet Burns, in a letter to his biographer, Mr. Cun.
ningham, in which he says :—“ Canst thou not minister
to a mind diseased? Canst thou not speak peace and
rest to a soul tossed on a seaof troubles, without one
friendly star to guide his course, and dreading that the
next surge may overwhelm him? If thou canst not do
the least of these, why should’st thou disturb me in my
miseries with thy enquiries after me?” In another
letter in which he refers to himself he says:—‘“TI have
been for some time pining under secret wretchedness.
The pang of disappointment, the sting of pride, and some
wandering stabs of remorse settle on my life like vul-
tures, when my attention is not called away by the claims
of society or the vagaries of the Muse. Even in the
hour of social mirth my gaiety is the madness of an
intoxicated criminal under the hands of an executioner.
My constitution was blasted, ab origine, with a deep in-
curable taint of melancholy that poisoned my existence.”
How accurately has old Burton, in his “ Anatomy of
Melancholy,” described the terrible sufferings of the
hypochondriac. He says:—‘ They are soon tired with
® wéraros XoAq.
MELANCHOLIA | 273
all things: they will now tarry, now begone; now in
bed they will rise, now up then they go to bed; now
pleased, and then displeased ; now they are like, then
dislike all. ‘ Sequitur nunc vivendi nunc moriendi, cupido,’
‘to quote Aurelianus. Discontented, disquieted upon
every light occasion or no ovcasion; often tempted to
make away with themselves; they cannot die, they will
not live; they complain, weep, lament, and think they
live a most miserable life; never was any man so bad.
Jealousy and suspicion torment them ; they are peevish,
distrustful with their best friends.” Charles Lamb
poetically delineates these unhappy persons :—
By myself walking,
To myself talking,
When I ruminate
On my untoward fate
Scarcely seem I
Alone sufficiently.
Black thoughts continually
Crossing my privacy:
They come unbidden,
Like foes to a wedding ;
Thrusting their faces
+ In better guests’ places.
Peevish and malcontent,
Clownish, impertinent :
So like the fashions,
Dim cognitions
Follow and haunt me,
Striving to daunt me.
Fierce anthropophagi,
Spectra diaboli.
What scared St. Anthony?
Hobgoblins, Lemures,
Dreams of antipodes,
‘Night-riding incubi.
In acute attacks of melancholia, it is often useless
to attempt to dissipate the morbid ideas that are so dis-
tressing the patient. He appears to take a pleasure in
T
Melancholia
described by
Burton.
Stages met
with in
dementia.
Dr. A.
Taylor's re-
marks on
dementia.
274 MANUAL OF LUNACY
hugging his imaginary sorrows, and steadily refuses to
be comforted. In the words of the poet, he exclaims :—
“Go! you may. call it madness,—folly,
You shall not chase my gloom away ;
There’s such a charm in melancholy,
I would not, if I could, be gay.”
Dementia (acute and chronic). This term is often
used synonymously with that of fatuity and idiocy, and
is divided into,
1. Dementia naturalis.
2. Dementia adventitia.
The first state is that of ¢diocy. The second refers
to persons .who originally possessed reasoning power.
Tt may be described as a general enfeeblement of the
intellect, and in some cases an apparent abolition of all
mental power. This state of intellect may arise from
accidental injury to the head, or may result from long-
continued disease of the brain affecting the operation of
thought. .
“ Dementia, when confirmed,” says Dr. A. 8. Taylor
in his valuable work on Medical Jurisprudenee, “is a
total absence of all reasoning power, an incapacity to
perceive the true relations of things; the language is
incoherent, and the actions are inconsistent ; the patient
speaks without being conscious of the meaning of what
he is saying ; memory is lost, and sometimes the word
or phrase is repeated for many hours together; words
are no longer connected in meaning, as they are in
mania and monomania. This state is often called fatuity;
it is not an unfrequent consequence of mania and mono-
mania.”
Curonic Dumentia is often the result of acute attacks
of insanity. Allintelligence appears to be abolished, and
the unhappy patient is reduced to the lowest degree
of fatuity, being utterly unable to understand any ques-
tion addressed to him. He ceases to obey the calls of
IMBECILITY 275
nature, is dirty in his habits, and is reduced -almost to
the level of the brute creation. Occasionally this state
of mental prostration is accompanied by sudden parox-
ysms of violence; but asa general rule these patients
are very tractable, and are easily controlled.
Inegcitiry may be either congenital or acquired.
The mind is often able to understand simple proposi-
tions, and the memory occasionally retains its power.
In this form of mental impairment the patient is sus-
ceptible of a certain degree of improvement, is facile to
the bad influence of other persons, is easily led in
consequence of an enfeeblement of volition. ‘All the
higher faculties of the mind are undeveloped, or but
slightly manifested. In this type of insanity the patient
is pronounced to be in legal phraseology ‘non compos
mentis,” or of unsound mind. Of course this term is
applicable to all forms of disordered mind, unfitting the
person for the management of himself or his affairs;
but is more generally applied to chronic forms of imbe-
cility or want of capacity, either the effect of congenital
defect of the brain, or some mechanical injury to the
head, or mental shock. This term, ‘“ unsound mind,”
originated .with the late Lord Eldon, and was intended
to convey the idea of a person not acutely insane, or
altogether imbecile or fatuous, but in such a condition
of intellect as clearly to unfit him for the management
of himself or government of his affairs.
Ipiocy may generally be defined undeveloped or ar-
rested intelligence, arising from malformation of the
cranium and defective organisation of the brain. It
may be a congenital or an acquired condition of intellect.
It is often an intra-uterine state, and is generally
manifested at birth. It is occasionally the effect of
some form. of disease of the brain, such as inflam-
mation, acute softening, and hydrocephalus, or the result
of mechanical injury to-the head during parturition.
T2
Imbecility
either con-
genital or
acquired.
Idiots as
defined by
Fitzherbert,
Dr. Ray on
idiocy.
276 MANUAL OF LUNACY
An idiot is defined by Fitzherbert to be ‘“ from birth
a person who cannot count or number twenty pence, or
tell who was his father or mother, nor how old he is.”
According to Lord Tenterden, an idiot, in strict legal
phraseology, is “a man who cannot repeat the letters of
the alphabet, nor read what is set before him: There
are degrees of idiocy. Occasionally there are faint, scin-
tillations of intelligence, and often the affections are
strongly manifested. even in advanced cases of this type
of mental weakness.
“Idiocy is that condition of mind in which the re-
flective, and all or a part of the effective powers, are:
either entirely wanting, or are manifested to the slight-
est possible extent. The intellectual and moral faculties,
in cases properly falling under this head, are almost null,
the effect being in most instances congenital, and arising
in all cases from want of development of the senses is
almost equally defective. The power of speech does
not exist, or exists only so far as to enable the patient to
articulate a few unintelligible monosyllables. This in-
capacity depends sometimes on the imperfect conforma-
tion of the organs of speaking, sometimes upon those of
hearing, but more frequently on a deficiency in or want
of the powers of imitation ; so that even when the hear-
ing and the speech are both entirely mature, the patient
remains unable to do more than in the one case to show
his knowledge of the existence of sound, and in the
other, to give utterance to noises not above, if equal to,
those of the brute creation. Taste and smell are equally
imperfect. In many cases there is an inability to per-
ceive odours, and in most, nothing but the coarsest
discrimination in the selection of articles of food.
Wallowing in personal filth, devouring even excrement
with apparent avidity, indisposition to eat at all unless
food be placed directly before the eye, drinking urine
with as little appearance of distaste as water, are inci-
IDIOCY | 277
dents one or more of which are to be found in almost
every case of idiocy. And the same low grade of
sensibility and of flexibility is found in the purely physi-
cal system. The nerves are almost torpid. Limbs
sometimes have been amputated without apparent pain,
and Esquirol even tells of labour having been undergone
without the patient being conscious of the fact or of its
meaning. The arms are frequently of unequal length,
and misshapen; and the limbs generally are crooked and
feeble. A careless and broken gait distinguishes them
in most cases. ven the eyes are defectively hung, and
seem incapable of poising themselves at a right level.
And in the lower class of cases there is sometimes so
, great a defectiveness of vision as to prevent the patient
from perceiving the most obvious objects. And even
when the powers of vision and of motion exist, the
intellectual powers are sometimes so attenuated as to
make attempts to reach a desired point entirely abortive,
though there be entire muscular power for such a pur-
pose.’’*
Idiots of the lowest class are mere organisms, masses
of flesh and bone in human shape, in which the brain
and nervous system have no command over the system
of voluntary muscles; and which consequently are
without power of locomotion, without speech, without
any manifestation of intellectual or affective faculties.
Fools are a higher class of idiots, in whom the brain
and nervous system are so far developed as to give
partial command of the voluntary muscles; who have
consequently considerable powers of locomotion and ani-
mal action; partial development of the intellectual and
affective faculties, but only the faintest glimmer of
reason, and very imperfect speech.
Simpletons are the highest class of idiots, in whom
the harmony between the nervous and muscular systems
* Dr. Ray.
Charac-
teristics of
idiocy.
Nyripho-
mania,
prohably a
disease of
cerebellum.
Distinction
between
kleptomania
and wilful
stealing.
278 MANUAL OF LUNACY
is nearly perfect; who, consequently, have normal
powers of locomotion, considerable activity of the
perceptive and affective faculties, and reason enough for
their simple individual guidance, but not enough for
their social relations.*
Nymrvomani4.—This insane condition of mind is
supposed to arise from an irritation or an enlargement
of the nymphe. Hence its name. But the disease is
generally cerebral, or in other words reflex, the effect
of disease or disorder of the brain, probably the cerebel-
lum. It may shortly be defined to be a morbid exalta-
tion of the sexual appetite associated with lascivious de-
sires and unnatural habits, not always, as is erroneously
supposed, the effect of local irritation. This disease
often attacks truly modest women, who heroically strug-
gle to keep in check this terrible malady. This morbid
affection is generally found to be associated with uterine
disturbance and catamenial irregularity.
Kurptomania.—In some forms of insanity patients
are often irresistibly impelled to steal, and to carefully
conceal what they pilfer from others. Within the pre-
cincts of most asylums these cases are met with. One-
lunatic will steal from another, or pilfer anything
they can lay their hands upon in the house. But these
cases are not made matters of public observation and
inquiry. It is only when this morbid propensity ex-
hibits itself in the higher or middle classes of society
outside of a lunatic asylum that it comes under judicial
notice, and is matter for legal investigation. It is
sometimes difficult to distinguish kleptomania from or-
dinary acts of theft. The circumstances of the alleged
crime or monomania are of course carefully to be consi-
dered. In numerous cases the unhappy patient (generally
female) is in good cireumstances at the time the imputed
offence was committed, having at command the means
* In accordance with Dr. Howe’s Classification of Idiocy.
KLEPTOMANIA 279
of purchasing’ all the necessaries and even luxuries of
life; and yet, with a purse full of money, she finds it
impossible to restrain on certain occasions her “ fingers
from picking and stealing.” Women of known honesty,
truth, intelligence, and worth, in full possession of
everything that can make life desirable, find it impos-
sible, when suffering from this malady, to resist this
insane propensity. It is often associated with physical
disorder of the nervous system—uterine irritation—
ovarian disease—general nervous debility and ill-health
—hysteria, &c. It is occasionally an hereditary malady,*
and is often seen to follow some shock, physical or
mental. It frequently manifests itself during the period
of utero-gestation, or shortly after childbirth, or an at-
tack of puerperal mania. All these particulars have.
carefully to be weighed and considered before forming
a diagnosis.
“There are persons,” says Dr. Rush, “who are
moral to the highest degree as to certain duties, but
who, nevertheless, live under the influence of some one
vice. In one instance, a woman was exemplary in her
obedience to every command of the moral law, except
one, she could not refrain from stealing. What made
this vice more remarkable was, that she was in easy
circumstances, and not addicted to extravagance in
anything. Such was the propensity to this vice, that
when she could lay her hands on nothing more valu-
* Alluding to the hereditary character of crime, a writer says:
—I was present one day at a factory or barrack in New South
Wales, where the convicts are kept until engaged by a master, when
a gentleman came in, and seeing a youth whom he thought would
suit him, said,‘ Well, lad, what are you?’ ‘A London thief,’ was
the boy’s reply, touching his hat. ‘What can youdo?’ ‘Thieve,
sir’ ‘No doubt of that; but how were you brought up?’ ‘To
thieve, sir’ ‘Nonsense; what was your father?’ ‘A thief, sir’
Upon further inguiry the gentleman ascertained that the boy had
jive brothers and five sisters, all of whom had been convicted thieves.”
Kleptomania
often here-
ditary.
Remarks by
Dr. Rush
on klepto-
mania.
Dr. Ray on
klepto-
mania.
280 MANUAL OF LUNACY
able, she would often, at the table of a friend, fill her
pockets secretly with bread. She both confessed
and lamented the crime.” ‘Cases like this,” says
Dr. Ray, “are so common, that they must have come
within the personal knowledge of every reader who has
seen much of the world, so that it will be unnecessary
to mention them more particularly. It would be diffi-
cult to prove directly that this propensity continuing
as it does throughout a whole life, and in a state of
apparently perfect health, is, notwithstanding, a con-
sequence of diseased or abnormal action in the brain;
but the presumptive evidence in favour of this explana-
tion is certainly strong. First, it is very often observed
in abnormal conformations of the head, and accom-
panied by an imbecile condition of the understanding.
Gall and Spurzheim saw, in a prison of Berne, a boy
twelve years old, who could never refrain from stealing,
He is described as ill-organised and rickety. At Hainau
they were shown an obstinate robber, whom no corporeal
punishment.could correct. He appeared about sixteen
years of age, though he was in fact twenty-six; his
head was round, and about the size of a child’s one year
old. He was also deaf and dumb, a common accom-
paniment of mental imbecility. An instructive case
has been lately recorded, in which this propensity
seemed to be the result of a rickety and scrofulous con-
stitution. Secondly, this propensity to steal is not
unfrequently observed in undoubted mania. Pinel says
itis a matter of common observation, that some maniacs,
who, in their lucid intervals, are justly considered
models of probity, cannot refrain from stealing and
cheating during the paroxysm. Gall mentions the
case of two citizens of Vienna, who, becoming insane,
were distinguished in the hospital for an extraordinary
propensity to steal, though previously they had lived
irreproachable lives. They wandered over the house
DELUSIONS, HALLUCINATIONS AND ILLUSIONS 281
from morning to night, picking up whatever they could
lay their hands upon, straw, rags, clothes, wood, &c.,
which they carefully concealed in their room.” *
Detvsions, Hattucmations anp Innustons. —It is
necessary to bear in mind the legal as well as medi-
cal definitions of these often-used. technical terms.
Lord Brougham defines delusion to be ‘‘a belief of
things as realities which exist only in the imagination
of the patient.” Sir John Nicholl says a delusion
is “a belief in a fact which no rational reason would
have believed.” Dr. Forhes Winslow thus defines the
word delusion: “a belief in the existence of some-
thing extravagant which in reality has no existence
except in the diseased imagination of the patient, the
absurdity of which he cannot perceive and out of which
he cannot be reasoned.”’ {| Dr. Winslow thus makes an
important legal distinction between the eccentric concep-
tions of a healthy and the morbid creations of a diseased
imagination and judgment.
HaLLucrnations are insane impressions made upon
the mind by external objects. Such patients often fancy
they see the apparition of persons long dead coming
into the room, or believe that they have been trans-
formed into various species of animals. Some fancy
that they are pregnant, are dead, or are made of
glass, butter, and wax. Others imagine that voices are
addressing them, speaking through the panels of the
room from or in the street, addressing them by name,
accusing them of certain crimes, or urging them to
commit suicide. The words, “ Kill yourself, kill your-
self!”? are words which the unhappy patient fancies
he hears addressed to him. The morbid phenomena of
those who so suffer are of an objective character.
Intustons are the effects of a morbid state of the
perceptions and are often combined with hallucinations.
* Ray “ On Insanity.”
. ¢ “Lettsomian Lectures on Insanity.”
Delusions
defined,
Hallucina-
tions.
Illusions.
Case related
by Esquirol.
282 MANUAL OF LUNACY
It is sometimes difficult to diagnose one state from the
other. Schiimayer defines illusions to be mistakes in
the conception and interpretation of the perception of
objects actually present; whilst in hallucinations, the
perception which originates in a diseased action of
the senses appears in the patient as if the sensation
were produced by a real object acting upon the senses.
Illusions are subjective phenomena. These false and
disordered impressions arise from an iternal cause.
Chronic and organic disease of the stomach, liver, or
bowels will often give rise in persons who become
insane to the idea that they are satanically possessed
and are undergoing the tortures of the damned; or that
a snake, frog, or reptile has been swallowed, and: is
gnawing their vitals, In cases of profound dyspepsia,
hepatic and intestinal derangement, the patient is often
under the illusion that his food is poisoned, that the.
head on his shoulders does not belong to him,* and that
everything he sees and touches is dirty or contaminated.
Esquirol relates a typical case of the kind. A
* A person who became insane during the French Revolution im-
agined that he had, with numerous other persons, been guillotined,
and that when Bonaparte was raised to power all the heads of the
guillotined persons were given to their respective owners. In the
scramble that then occurred to regain the lost heads, he had got
the wrong one, and under this delusion he went about shouting
in great misery, ‘‘This is not my head,” ‘These are not my teeth,”
“These are not my eyes,” “Give me my own head,” “This head
belongs to another person.” Tom Moore thus alludes to this
singular case in his ‘Fudge Family in Paris” :— ~
‘“‘Went to the Madhouse—saw the man,
Who thinks, poor wretch, that while the Fiend
Of discord here full riot ran,
He, like the rest, was guillotin’d ;
But that when under Boney’s reign
(A more discreet, though quite as strong one)
The heads were all restor'd again,
He in the scramble got a wrong one.”
DELIRIUM AND INSANITY 283
lunatic was for the greater part of his life under the
delusion that he had a wolf inside him. After death
it was discovered that he had for many years been
afflicted with cancer of the stomach. Occasionally these
patients imagine they are being pursued or watched by
the police; and that they are to be tried for some im-
aginary crime,
When in extremis, and in certain forms of low fever,
patients are often seen picking the sheets and blankets
under the delusion that insects are crawling over the
bedclothes.
Detiriem (de, lire) off the tract, or the mind off its
balance. This is a temporary mental disorder, often
caused by acute bodily disease, such as fever, typhoid,
puerperal, and typhus, renal disease, abuse of stimulants
causing deliriwm tremens.* The latter form of delirium
is associated with delusions and hallucinations, especially
of the senses, but they are usually not of a fixed and
permanent charaéter like those seen in actual insanity.
The delusions in delirium are constantly changing and .
are transient in their manifestations.
* “ The experienced physician is not likely to confound delirium
tremens, clearly the consequence of an excessive indulgence in, or
the effect of a sudden abstraction of stimulants from the brain, with
insanity. The acute accession of the delirium, remarkable insomnia
which precedes its development, and continues through its course;
peculiar muscular tremor; anxiety and distress of mind so charac-
teristically marked in the physiognomy, the fussy and busy nature
of the delirium, fumbling of the bedclothes, extreme lequacity of
the patient, peculiar, sensorial illusions and mental hallucinations,
suffused face, injected conjunctive, soft and feeble pulse, moist and
creamy tongue, wild look .of suspicion, terror, and alarm, clammy
state of the skin, accompanied by a peculiar cutaneous exhalation
similar to that observed in rheumatism, and perfectly obvious to the
sense of smell, great: agitation of manner, and increasing restlessness,
are all specific and peculiar diagnostic features of this type of cere-
bro-mental disorder, clearly distinguishing it from the ordinary and
specific forms’ of insanity.”— Obscure Diseases of the Brain and
Mind; by Forbes Winslow, M.D., D.C.L., Oxon., 4th edition.
Delirium.
Distinction
between
delirium and
insanity.
The brain
functionally
or organi-
cally af-
fected in
delirium,
Dipsomania
often con-
founded with
ordinary
drunken-
ness,
284 MANUAL OF LUNACY
Great caution should be exercised before signing a cer-
tificate in a case of deliriwm tremens with the object of
placing such patients in a lunatic asylum. In a few
instances it is absolutely necessary to do so, but, as a
general rule, if properly treated they recover at home.
Personal or mechanical restraint, except in extreme
cases, should always be avoided.
In forming a diagnosis between delirium, the result
of active bodily disease, and the delirium of insanity, it
should be borne in mind that the delusions in true
delirium are often evanescent, and are generally accom-
panied by some acute form of bodily disorder, as
cerebritis or meningitis, &c.
In insanity the delusions are more fixed and are
often apparently independent of any acute bodily disease,
though as a rule we find insanity associated with a bad
state of physical health.
In all forms of delirium and disordered mind the
brain is either functionally or organically affected. No
_mental derangement can occur unless the brain, the seat
of thought, is disordered (not necessarily structurally).
The vessels may be congested, the blood poisoned,
or the membranes of the brain may be undergoing
changes, all of which often give rise to delirium.
There may be extensive organic disease of the brain,
tubercles, abscess, and even ramollisement or induration
of the brain, without the mind being at all affected;
but directly the cenerttious or cortical structure is in-
volved, the mind and mental faculties are immediately
implicated. No disorder of the vesicular neurine can
take place without mental disturbance.
Dipsomanta—chronic alcoholism, as it is sometimes
termed. It is often difficult to distinguish this form of
mental disease from ordinary attacks of drunkenness.
The attacks of dipsomania are generally paroxysmal,
and associated with some form of brain disorder or
DIPSOMANIA 285
mental or bodily ill-health. The patient has often re-
gular lucid intervals—id est, he will abstain from stimu-
lants for a considerable time—and then suddenly have a
relapse, and indulge freely in their use. In numerous
cases the patient is conscious of his infirmity, and bit-
terly laments his inability to control his morbid crav-
ing for intoxicating drinks. He will affirm that he has
no real pleasuré in this indulgence, but finds the habit
irresistible and uncontrollable. He apparently strug-
gles against the propensity, and for a time succeeds in
mastering the passion; but in some cases the slightest
smell or taste of alcoholic drinks induces a paroxysm of
the disease, and he then drinks till he becomes brutally
intoxicated. The true dipsomaniac bitterly deplores his
unhappy condition, and begs that measures to restrain
him may be adopted. Often these patients voluntarily
place themselves under restraint in asylums; but when
restored to sane sobriety it is difficult, in consequence of
the absence of delusions, to retain them as patients. The
Commissioners in Lunacy, however, in some chronic
cases sanction the detention of these invalids, even after
apparent recovery, provided they show signs of un-
doubted mental disorder, exhibiting itself in an insane
desire for stimulants.*
The subjoined quotations in relation to this subject
I extract with the permission of the author :—*+
“Tn these cases the morbid craving for physical sti-
* When alluding to this subject the Commissioners observe :—
“ We have considered that a lunatic asylum is not a place for the
permanent detention of persons who have recovered the use of their
reason, and are not obnoxious to the charge of unsoundness of mind
otherwise than on account of the liability to run into their former
excesses when restored to liberty.”
. t “On Uncontrollable Drunkenness eonsidered as a Form of
Mental Disorder, with- Suggestions for its Treatment, and the
Organisation of Sanatoria for Dipsomaniacs.” By Forbes Winslow,
M.LD., D.C.L. Oxon.
Dr. Forbes
Winslow on
dipsomania,
Want of
control ex-
hibited by
dipso-
maniacs.
286 MANUAL OF LUNACY
muli of ail kinds is uninfluenced by any motives that
can be addressed to the intellect, heart, or conscience,
Self-interest, self-esteem, friendship, love, religion,
morality, are appealed to in vain. The passion for in-
toxicating drinks paralyzes the will and obtains a com-
plete mastery over the understanding and moral sense,
making every other emotion of the soul subservient to
its base and demoralizing influences.
“This disposition for stimulants is often associated
with an intense horror of the practice. The invalid (for
so he must be considered) is often painfully conscious of
his infirmity, and: bitterly laments his inability to con-
quer the disordered appetite.
“When speaking of this mental malady, Esquirol
says: ‘Si Vabus de liquewrs alcooliques est un effet de
Vabrutissement de Vesprit, des vices de l'éducation, des
mauvais exemples, iL y a quelquefois un entrainement
mualadif qui porte certains individus ad abuser des bois-
sons fermeniées. Il est des cas dan lesquels lwresse
est Veffet du trouble accidentel de la sensibilité physique
et morale, gui ne laisse plus & Vhomme sa liberté d’ action.’
“ So intensely developed in many cases is this yearn-
ing for intoxicating stimulants that the unhappy victim
allows no sense of decency, no feeling of propriety, no
regard for family or domestic ties, to stand for a single
instant in the way of his sensual indulgence. As in
éther forms of disordered intellect and perverted’ in-
stinct, the most remarkable cunning and ingenuity are
frequently exhibited by the patient in his endeavours to
- obtain access to stupifying drink. I have, in my own
experience, known both men and women (occupying
high social positions) of decided genius, of wonderful
attainments, and cultivated intellectual taste, fall a prey
to this form of insanity, and become utterly wrecked in
mind, body, and estate.
“ It is difficult for those unprofessionally conversant
DIPSOMANIA 287
with these cases to appreciate the extent to which this
vice prevails in all ranks of society, and the difficulties
connected with its successful treatment. In the ma-
jority of instances, and in those too where the habit of
intemperance has reduced the person almost to the level
of the beast, the ordinary reasoning powers for a time
appear to be intact, and the mind is apparently free
from the influence of delusions, hallucinations, or any
other form of mental alienation. The person, when not
actually muddled by drink, talks rationally, consecu-
tively, and often with great acuteness and sagacity.
Hence the medical and legal difficulties that arise when
asked what amount of personal interference can be im-
posed in such cases with the view of destroying the
insane impulse to drink, and of saving the patient, if
not from a horrible death, at least from irretrievable
ruin. It is absurd, except in cases where the mind has
become decidedly disordered or impaired, to tall about
placing such patients as lunatics in public or private
asylums. If it were thought desirable so to confine
and treat them with a view of re-establishing the bodily
health and restoring the lost, or I should say, suspended
power of self-control, the law very properly would not
‘permit it. It is only when the mental disorder from
intemperance culminates in a commonly-recognised form
of insanity that the law interferes to save the individual
from himself, and to protect his relatives and friends, or
the community.
“During the whole of the nascent and maturing
stages of the alienation,.during the progressive degra-
dation of the moral faculties of the individual, the
medical man is compelled to look on, and witness the
most heart-rending ruin of a family, often in soul in-
dividually as well as in worldly possessions, by one
whose intemperance is the manifestation of a trué insane
impulse, hereditary or acquired. The control of friends
Inability to
deal legally
with dipso-
maniacs.
Homicidal
insanity
generally
associated
with melan-
cholia,
Dr. Forbes
Winslow on
moral in-
sanity.
288 MANUAL OF LUNACY
or relatives, experience shows fails utterly, as a rule, to
destroy the morbid propensity for drink.”*
Howicipat Insantty.—In this form of lunacy there is
often an absence of all impairment or aberration of the
intellectual powers, but in numerous cases delusions are
detected. Patients predisposed to this form of madness
are liable to sudden paroxysms of murderous violence.
Occasionally they appear to be influenced by the most
trifling exciting cause, and in numerous cases the crime
appears to be entirely motiveless. An intense desire to
destroy the lives of those whom they most tenderly love
overpowers the reason and will of the unhappy sufferer.
In this type of insanity there is generally found symp-
toms of melancholia associated with strange erratic con-
duct. These patients are gloomy and morose, combining
often with the ferocity, the cunning, of the tiger. This
phase of mental disorder is frequently classed under the
head of :
Morat Insanity. On this subject I cannot do better
than quote the following passage, as it fully describes
this form of lunacy :—
“ Let me consider the subject of ‘moral insanity,’ or,
as Pinel terms it, ‘ emportement maniaque sans délire, not
pathologically but metaphysically. All authorities agree
in opinion, that the specific characteristics of this form
of derangement are dependent upon a lesion of the
* Drunkenness cannot be pleaded in excuse for crime. The
drunkard is, in the words of Lord Coke, “ Voluntariusdemon.” His
drunkenness aggravates his offence: “ommne crimen ebrietas et in-
cendit et detegit.” (Coke on Litt. 274, a.). Baron Alderson told a
jury that ‘if a man chooses to get drunk it is his own voluntary
act: it is very different from madness, which is not caused by any act
of the person.” (This is not psychologically accurate). Baron Parke
declared that ‘if a man makes himself voluntarily drunk it is no
excuse for any crime he may commit whilst he is so.” According
then to the English law, drunkenness is no valid defence in a
criminal case. ¢
HOMICIDAL INSANITY 289
affective or motive powers of the mind, apart altogether
from disorder of the intellectual faculties, or powers of
ratiocination. In the first place, I would ask, whether
the disease so designated is purely an affection of the
moral faculties ; and whether, as metaphysicians, we are
justified in drawing so palpable a line of demarcation
between those faculties of the understanding that reason,
judge, compare, reflect, and those that supply motives
to the reason, and are termed, by metaphysicians, the
active principles of the mind ?
“ Viewing the question under review pathologically, I
ask whether, in cases of insanity which are represented
to consist in lesions of the will—in ungovernable im-
petuosity of temper—loss of self-control—perversion of
the affections and propensities—cases in which the
mental alienation is manifested more in conduct than in
ideas—where the delirium is apparently confined to the
actions and moral sentiments ;—whether, in this form of
mental derangement, the intellect, the reasoning and
reflective powers are not more generally disordered than
we have hitherto admitted? In many instances of
mental disease, considered as uncomplicated illustrations
of moral insanity, the malady ¢s not confined to the affective
or motive faculties. I do not maintain that such is
apparent in every case of impairment of the moral sense
or motive power; but I have detected the intellectual
aberration in many cases brought under my observation
as instances of pure derangement of the conduct, pro-
pensities, passions, appetites, and moral affections. In
nearly all of them we may, upon a close logical analysis,
perceive, co-existing with the moral disorder, a derange-
ment of those powers of the mind by which we compare
facts with each other, and mental impressions with ex-
ternal things; to speak with metaphysical exactness,
and philosophical as well as philological precision—by
which we appreciate the perception of relation. If we
U
Dr. Forbes: -
Winslow on
moral in-
sanity.
Dr. Forbes
Winslow on
moral in-
sanity.
290 MANUAL OF LUNACY
carefully investigate the cases quoted by Pinel, Esquirol,
and Prichard, and referred to as types of moral insanity,
we are irresistibly led to the conclusion, that the malady,
as described by these authorities, was not in any one
case restricted to the affective or motive powers of the wn-
derstanding. The faculties of judgment, reason, and
comparison are represented in this form of insanity to
be healthy and intact. Apparently, upon a superficial ,
examination, they may be so; but do not the ‘ tyrant
passion ’—predominant vice—overpowering emotion—
loss of self-respect—brutality of conduct—prostration of
all the more refined sensibilities of the mind—uncon-
trollable impulse—impetuous will—and the suicidal or
homicidal idea, during the crisis of the paroxysm, and
contemporaneously with the commission of the act, dethrone
reason, and paralyze the operations of the judgment?
Do not violent and ungovernable temper, impulsive
emotion, and unreasonable conduct, leading to overt acts
of what are termed moral insanity, suspend the exercise”
of the will, and interfere with the healthy balance or
equilibrium of the intellectual faculties ? In cases where
the faculty of volition appears to be suspended, and the
patient is unhappily the willing and facile slave of every
wicked, sensual appetite and vicious propensity, and-is
guilty of most extravagant conduct—are, I repeat, the
powers of judgment, reason, and comparison, the more
exalted and intellectual functions of the mind, entirely
free, unclouded, unfettered, and in a healthy state of
activity? Is the ‘moral maniac’ capable of pursuing
an ordinary and healthy process of induction, and com-
petent to exercise the powers of reason, comparison, and
reflection, guoad the specified features of his so-termed
‘moral’ disease? He may be apparently of sound un-
derstanding, able to solve with great rapidity a difficult
mathematical problem; have great capacity for the
ordinary business of life ; may converse with ease upon
MORAL INSANITY 291
e
points of science, art, and philosophy ; and astonish the
world by the tenacity of his memory, the vividness of
his fancy, the playfulness of his satire, the brilliancy
of his wit, and the majesty and sublimity uf his eloquence
——all these elevated states of mind are compatible with
latent delusive ideas and imtellectual disorder.* Lord
Brougham makes some pertinent remarks on this sub-
ject. When applying his able powers of philosophical
analysis to this question, his Lordship observes: ‘We
cannot with any correctness of language speak of general
or “partial”’ insanity; but we may most accurately
speak of the mind exerting itself in consciousness with-
out cloud or imperfection, but being morbid when it
fancies ; and so its owner may have a diseased imagina-
tion, or the imagination may be diseased, and yet the
memory may be impaired, and the owner be said to have
lost his memory. In these cases we do not mean that
the mind has one faculty, as consciousness, sound, whilst
another, as memory or imagination, is diseased ; but
that the mind is sound when reflecting upon its own
operations, and diseased when exercising the combination
termed imagination, or casting the retrospect called re-
flection.’ Then again, as to what is termed impulsive
insanity, a form of. disease generally considered to be
unassociated with derangement of the ideas, I would
ask, is it a fact that these cases are invariably unaccom-
panied by delusive impressions, or by a disturbance of
* “In many cases, designated as illustrations of moral insanity,
I feel assured that undetected and unrecognised delusions often
actually exist, influencing the conduct of the patient. I could nar-
rate several instances of the kind. .M. Marc mentions the case of a
man, who for many years had been in the habit of licking the walls
of the apartment with his tongue, until he had actually worn away
the plaster. No one could imagine what was the cause of this per-
severance in so painful and disgusting a habit, until one day in the
author’s presence he confessed that he tasted and smelt the most
delicious fruit on the walls.” ;
u2
Dr. Forbes
Winslow on
moral in-
sanity.
Moral in-
sanity.
Puerperal
mania
generally
immediately
following
confine-
ment,
292 MANUAL OF LUNACY
the reasoning faculties? Admitting the existence of a
morbid impulsive propensity, does it become absolutely
irresistible and uncontrollable except during a crisis of
delirium ? It has been maintained, that at the moment
of the impulsion an intellectual perturbation and posi-
tive derangement of ideas occurs. ‘ We believe,’ says a
French writer, ‘that the doctrine of a temporary in-
sanity, of a sudden eclipse of the reason at the time of the
act, is a safer and more philosophical doctrine than the
hypothesis of modern medical jurists, who assert that no
monomania, whether homicidal, suicidal, or incendiary,
can compel to the consummation of the act, without in-
sanity in the ordinary acceptation of the term, or intel-
lectual disturbance. We repeat that we cannot admit
this theory or principle of monomania with irresistible
desire, and without delirium during the act, because it
appears to us to be dangerous, inasmuch as it suspends
the course of free-will, is destructive of the morality of
human actions, and tends to favour impunity of crimes.
For if the impulse be irresistible, and is unaccompanied
by delirium during the act, what becomes then of free-
will? In our minds, the disturbance of the reason will
always be more comprehensible and conformable to the
common-sense of mankind than a perversion of the will
without delirium.’ ’’ *
PUERPERAL Mania may occasionally precede parturi-
‘tion, but, as a general rule, it follows delivery. The
insanity in these cases is more of the character of
delirium, especially in its early stage, than that of true
mental derangement. The patient is often troubled
with hallucinations and illusions instead of any fixed
delusions, although these occasionally crop up. This
form of lunacy is often associated with a desire to
murder or injure the infant. In the acute stage the
* “TLettsomian Lectures on Insanity,” by Forbes Winslow, M.D.,
D.C.L., Oxon.
PARALYSIS OF THE INSANE 293
patient and child require to be closely watched. These
cases are generally curable, and ought not to be re-
moved from home. In some chronic forms of the
malady it is absolutely necessary to place the patient
under surveillance with a view to efficient remedial
treatment.
GeNnERAL Paratysis or THE Insanz.—This mental
affection is often caused by organic changes in the
membranes or substance of the brain, 4nd is associ-
ated with morbid conditions of the mind, muscular
system, and speech. It is a most insidious malady, and
it is most difficult to trace its origin. It is characterised
by three distinct and well-marked stages. In the early
stage the mind becomes affected by exalted or ambitious
delusions ; the patient, probably imagining that he is
in possession of a large amount of property, will
order various things for which he has no use, and at
the same time no money to pay for; he will also draw
cheques upon banks in which he bas no effects, being
under the delusion that he has vast resources at his
command, and under the influence of these false impres-
sions if not restrained he will beggar himself and his
family. He may fancy that he has gigantic strength,
and that itis in his power to accomplish anything he may
attempt, or that he is a regal personage, and will conse-
quently dress up in extravagant costumes. The patient
is completely wrapped up in his own ideas of grandeur,
and nothing can persuade him that he is labouring under
false impressions. All these symptoms are characteristic
of the first stage of general paralysis of the insane. We
have in addition great loquacity, restlessness, and defec-
tive memory for recent events.
In the second stage of the disease paralysis becomes
evident, the first indication showing itself in the speech,
which igs thick; he articulates with difficulty and speaks
General
paralysis of
the insane.
First stage.
Second
stage.
Third stage.
Detection of
feigned in-
sanity.
294 MANUAL OF LUNACY
with a muffled voice resembling very much the articula-
tion of a drunken man, and as if the tongue were too
large for the mouth. He is unable to give utterance to
certain words, or pronounce particular letters of the al-
phabet. There is an uncertainty in his gait, and loss of
power, especially in the lower extremities, is very ap-
parent. The delusions existing in the first stage of the
disease are also present, the memory and other faculties
of the mind are much impaired, and there is an entire
absence of all moral feeling.
In the third stage of this disease the patient passes
into a state of helpless dementia, he cannot recognise
his immediate friends and relatives, he is completely
paralysed, very dirty in his habits, and entirely lost
as to what goes on about him. In this stage he re-
mains until death terminates his unhappy existence.
Frienep oR Simutarep Insanity.—Insanity is often
feigned by the criminal to escape punishment, or by
‘the soldier to obtain his discharge from the army. In
these cases the pseudo-lunatic overacts his part, so
that the experienced eye of the skilled physician ought
not to be easily deceived. These cases, however, require
to be under close observation for a time before the im-
position can be detected. It is occasionally necessary
to watch the person closely by day and night in order
to discover the simulation, The tests are the phy-
siognomy, the appearance of the eyes, the character of |
the voice, and feigned incoherence of the conversa-
tion, the absence of all bodily illness usually accom-
panying cases of insanity. It will be easy to distinguish
the nonsensical gibberish of a person feigning insanity
from the disjointed, rambling, incoherent conversation
of a bond fide madman. It is not easy to describe the
difference, but an expert will have no difficulty in de-
tecting it. In all suspected cases it may be necessary
SIMULATED INSANITY 295
to get the alleged lunatic to put in writing his ideas, to
associate him with other lunatics, and then observe his
conversation and conduct. Occasionally the mask is
thrown off when it is proposed in the patient’s presence
to use some very painful local remedies with the view
of curing his insanity, such as the actual cautery,
shaving and applying blisters to the scalp. The dread
of a prolonged shower bath has had the effect of dis-
covering feigned insanity. Monomania cannot be easily
simulated. The physician accustomed to observe these
cases ought not to be baffled. When feigning inco-
herence the person generally talks a quantity of bosh
from ignorance of the true characteristics of the disease
which the skilled medical man has never heard a
really insane person indulge in. This phenomenon is
well pourtrayed by Sheridan in the Critic, where he
makes Tilburina thus imitate the ravings of a lunatic :—
«“ The wind whistles—the moon rises—see
They have kill’d my squirrel in his cage!
Is this a grasshopper ?—Ha! no; it is my
Whiskerandos—-you shall not keep him—
I know you have him in your pocket—
An oyster may be cross’d in love !—Who says
A whale’s a bird? Ha! did you call, my love?—
He’s here! he’s there !—He’s everywhere!
Ah me! he’s nowhere!”
In Sheridan’s case of mimic madness the simulation is
said to have been detected by the “ mangled metre!”
Contrast the gibberish uttered by Sheridan’s mock
madwoman with the truthful delineation of the insane
ravings of Poor Tom, as pictured by the immortal
bard :—“ Who gives anything to poor Tom? whom the
foul fiend hath Jed through fire and through flame,
through ford and whirlpool, over bog and quagmire ; that
hath laid knives under his pillow, and halters in his pew ;
set ratsbane by his porridge ; made him proud of heart,
Feigned
insanity.
Feigned
insanity.
296 MANUAL OF LUNACY
to ride on a bay trotting-horse over four-inch’d bridges,
to course his own shadow for a traitor.”
Again, compare the incoherence of Sheridan’s poetic
lunatic with the ipsissima verba of Dr. Rush’s madman,
_and the difference between the conversation of an imagi-
nary lunatic and the disjointed language of a person
really insane will at once be recognised :—‘No man
can serve two masters. I am King Philip of Mace-
donia, lawful son of Mary Queen of Scots, born in
Philadelphia. I have been happy enough ever since I
have seen General Washington with a silk handkerchief
in High Street. Money commands sublunary, things,
and makes the mare go; it will buy salt mackerel, made
of tenpenny nails. Enjoyment is the happiness of
virtue. Yesterday cannot be recalled. I can only
walk in the night-time, when I can eat pudding enough.
I shall be eight years old to-morrow. They say R. W.
is in partnership with J. W. I believe they are about
as good as people in common—not better, only on
certain occasions, when, for instance, a man wants to
buy chin-copins, and to import salt to feed pigs.
Tanned leather was imported first by lawyers. Morality
with virtue is like vice not corrected. L. B. came into
your house and stole a coffee-pot in the twenty-fourth
year of his majesty’s reign. Plum-pudding and Irish
potatoes make a very good dinner. Nothing in man
is comprehensible to it. Born in Philadelphia. Our
forefathers were better to us than our children, because
they were chosen for their honesty, truth, virtue, and
innocence. The Queen’s broad R. originated from a
British forty-two pounder, which makes too large a
report forme. J have no more to say. I am thankful
I am no worse this season, and that I am sound in
mind and memory, and could steer a ship to sea, but
am afraid of the tiller * * * * * * * gon
MEDICAL EVIDENCE IN COURT 297
of Mary Queen of Scots. Born in Philadelphia. King
of Macedonia.” *
Medical Evidence in Court.
The medical man, when called upon to give evidence,
should abstain from the use of pedantic terms and tech-
nical phraseology.
The more simple, unaffected, and unadorned his
statement, the greater will be its moral weight. He
should carefully and scrupulously avoid all positiveness,
dogmatism, and partisanship. His testimony ought to be
accompanied with judicious qualifications, when relating
to cases of difficulty, doubt, and obscurity, respecting
which there may, even among scientific men, be great
discrepancy of opinion. His evidence should impress
the Court with the conviction that his opinion has
not been hastily, indiscreetly, or rashly formed. It
should appear as the result of a full, careful, and scien-
tific consideration of the case.
Having a lucid conception of the nature of the
evidence he is prepared to give, he should quietly and
firmly maintain his position, and not allow himself to
be confused or driven from his point by the cunning
artifice of counsel, or thrown off his guard by the re-
marks of the court.
He should be careful not to lose his temper, or to
indulge in witticisms or retorts upon the counsel.
Many witnesses seriously commit themselves by an
undue loquacity. This fault, and it is a prevalent and
a very serious one, cannot be too carefully guarded
against.
The witness had far better keep to the text; answer
the questions tersely and epigrammatically, and if called
* Dr, Rush on the Mind, pp. 242-8.
Duties of
medical
witness in
Court.
Duties of
medical
witness in
Court.
298 MANUAL OF LUNACY
upon for a further explanation, it should be brief and to
the point.
All attempts at a definition of insanity should be
carefully avoided. ~
The counsel who knows the obscurity of the subject,
and the difficulty with which the medical witness has
to contend in giving an accurate definition of insanity,
most unfairly endeavours to pin him down to one; and
then, by demonstrating the fallacy of his definition,
to overthrow the whole moral effect of his testimony.
If the witness be asked to define insanity, it will be
more judicious for him at once to candidly acknowledge
his utter incapacity to do so—
For to define true madness,
What is’t ? but to be nothing else but mad.*
* Hamlet.
LUNACY act, 1845: 8 & 9 vicr. c. 100 299
APPENDICES.
—
I.
ANNO OCTAVO & NONO VICTORLZ REGINA.
cap. 100,
An Act for the Regulation of the Care and Treatment of Lunatics,
August 4, 1845,
Bz it enacted by the Queen’s most excellent Majesty, by and
with the advice and consent of the Lords Spiritual and
Temporal, and Commons, in this present Parliament assembled,
and by the authority of the same, That fromand after the passing
of this Act an Act passed in the Session of Parliament holden
in the second and third years of the reign of his late Majesty
King William the Fourth, intituled ‘“ An Act for regulating for
three years, and from thence until the end of the then next
Session of Parliament, the Care and Treatment of Insane
Persons in England ;” and an Act passed in the Session of Parlia-
ment holden in the third and fourth years of the reign of his said
late Majesty, intituled, “An Act toamend an Act of the second
and third year of his present Majesty, for regulating the Care
and Treatment of Insane Persons in England;” and an Act
passed in the Sessionof Parliament holden in the fifth and sixth
years of the reign of his said late Majesty, intituled “ An Act
to continue for three years, and from thence to the end of the
then next Session of Parliament, two Acts of the second and
third year and the third and fourth year of his present Ma-
jesty, relating to the Care and Treatment of Insane Persons in
‘England; ” and an Act passed in the Session of Parliament
holden in the first and second years of the reign of her present
The follow-
ing Acts
repealed,
except as
they repeal
other Acts:
2&3W.
4.¢. 107,
&4w.
c. 64,
oe
a
Bq
5 Vict. c. 4,
5 & 6 Vict.
ce. 87.
Proviso
that present
Visitors and
Clerk shall
act under
this Act till
new ones are
appointed ;
and that
Licences
heretofore
granted
shall remain
in force,
unless, &c.
Commis-
sioners in
Lunacy
under
5 & 6 Vict.
c. 84, to be
300 MANUAL OF LUNACY
Majesty, intituled “An Act to continue for three years, and
from thence to the end of the then next Session of Parliament,
two Acts relating to the Care and Treatment of Insane Persons
in England;” and an Act passed in the Session of Parliament
holden in the fifth year of the reign of her said present Ma-
jesty, intituled “An Act to continue for three years, and from
thence to the end of the then next Session of Parliament, two
Acts relating to the Care and Treatment of Insane Persons in
England;” and an Act passed in the Session of Parliament
holden in the fifth and sixth years of the reign of her said pre-
sent Majesty, intituled ““An Act to amend, and continue for
three years, and from thence to the end of the next Session
of Parliament, the Laws relating to Houses licensed by the
Metropolitan Commisstoners and Justices of the Peace for the
Reception of Insane Persons, and for the Inspection of County
Asylums and Public Hospitals for the Reception of Insane
Persons,” shall be and the same are hereby repealed, save and
except so far as they or any of them repeal any other Act:
’ Provided always, that until the appointment for any Jurisdic-
tion of Visitors and their Clerk under the provisions of this
Act the Visitors and Clerk appointed for such Jurisdiction
under the said repealed Acts or any of them shall respectively
have and perform the powers, authorities, and duties which
they would have respectively had or performed if appointed
under this Act: Provided also, that all licences heretofore
granted shall remain in force for the periods for which they
were respectively granted, unless revoked as hereinafter pro-
vided ; and that all orders, matters, and things which have
been granted, made, done, -or directed to be done in pursuance
of the said repealed Acts or any of them shall be and remain
as good, valid, and effectual to all intents and purposes as if
the said repealed Acts had not been repealed, except so far as
such orders, matters, or things are expressly made void or
affected by this Act; and that all fees, charges, and expenses
which have become payable under the said repealed Acts or
any of them shall be payable in the same manner and from
the same funds as would have been applicable thereto in case
such Acts had not been repealed.
2, And be it enacted, That the persons already appointed
and hereafter to be appointed under an Act passed in the
Session of Parliament holden in the fifth and sixth years of
the reign of her present Majesty, intituled “An Act to alter
Lunacy act, 1845: 8 & 9 viet. c. 100 301
and amend the Practice and Course of Proceeding under
Commissions in the Nature of Writs De lunatico inquirendo,”
whereby the Lord Chancellor is empowered to appoint two
persons, to be called “The Commissioners in Lunacy,” shall
henceforth be and be called “The Masters in Lunacy,” and
shall take the same rank and precedence as the Masters in
Ordinary of the High Court of Chancery.
3, And be it enacted, That the Right Honourable Lord
Ashley, the Right Honourable Lord Seymour, the Right
Honourable Robert Vernon Smith, Robert Gordon of Lewis-
ton in the County of Dorset, Esquire, Francis Barlow of
Montagu Square, Esquire, Thomas Turner of Curzon Street,
Esquire, Henry Herbert Southey of Harley Street, Esquire,
John Robert Hume, of Curzon Street aforesaid, Esquire,
Bryan Waller Procter of Gray’s Inn, Esquire, James William
Myilne of Lincoln’s Inn, Esquire, and John Hancock Hall of
the Middle Temple, Esquire (which said Thomas Turner,
Henry Herbert Southey, and John Robert Hume, and no
other of the said persons, are physicians, and which said Bryan
Waller Procter, James William Mylne, and John Hancock
Hall, and no other of the said persons, are practising barristers
at law of ten years’ standing at the bar and upwards), and
their respective successors, to be appointed as hereinafter pro-
vided, shall be Commissioners for the purposes of this Act, to
be called “The Commissioners in Lunacy;” and that such
Commissioners for the time being shall respectively hold their
offices during good behaviour, and shall not, so long as they
shall remain such Commissioners, and receive any salary under
this Act, accept, hold, or carry on any other office or situation,
or any profession or employment, from which any gain or profit
shall be derived; and that there shall be paid to each of the
six Commissioners for the time being who shall be physicians,
surgeons, or barristers of five years’ standing and upwards,* out
of the moneys or funds hereinafter mentioned, over and above
their respective travelling and other expenses whilst employed
in visiting any houses, hospitals, asylums, gaols, workhouses,
or other places, in pursuance of this Act,-the yearly salary of
one thousand and five hundred pounds, by four equal quarterly
payments, on the twenty-ninth day of September, the twenty-
fifth day of December, the twenty-fifth day of March, and the
* See 16 & 17 Vict. c. 96; 8. 89.
henceforth
called “ The
Masters in
Lunacy.”
Appoint-
ment of
« The Com-
missioners
in Lunacy.”
In case of
death, dis-
qualifica-
tion, refu-
sal, or ina-
bility of
Commis-
sioners,
others to be
appointed.
Provision
for retiring
pension to
incapaci-
tated Com-
missioners.
4&5W.4.
c, 24,
302 MANUAL OF LUNACY
twenty-fourth day of June in every year, the first of each such
payments (or a proportionate part thereof, tv be computed, in
the case of the Commissioners appointed by this Act, from the
passing of the Act, and in case of the Commissioners t6 be
appointed as hereinafter provided, from the time of the re-
spective appointments of such Commissioners) to be made to
such Commissioners respectively on such of the same days of
payment as shall first happen after the passing of this Act, or
after the dates of their respective appointments, as the case
may be.
4, And be it enacted, That as often as any Commissioner
appointed by this Act or to be appointed under this present
provision shall die, or be removed for ill-behaviour, or be dis-
qualified, or resign, or refuse to act, or become unable by ill-
ness or otherwise to perform the duties or exercise the powers
of this Act, the Lord Chancellor shall appoint a person to be
a Commissioner in the room of the Commissioner who shall
die, or be removed, or be disqualified, or resign, or refuse or
become unable to act as aforesaid, but so that every person so
appointed in the room of a physician shall be a physician or
surgeon, and every person so appointed in the room of a bar-
rister of five years’ standing at the bar * and upwards shall be a
practising barrister of not less than five years’ standing at the
bar, and every person appointed in the room of any other
Commissioner shall be neither a physician nor a surgeon, nor
a practising barrister; and until such appointment it shall be
lawful for the continuing Commissioners or Commissioner to
act asif there were no such vacancy.
5. And be it enacted, That any superannuation allowance
to be granted to any Commissioner appointed or to be appointed
under this Act shall be granted only in respect of services
performed under this Act, and shall be subject to the provi-
sions of an Act passed in the fourth and fifth years of his late
Majesty King William the Fourth, intituled “ An Act to alter,
amend, and consolidate the Laws for regulating the Pensions,
Compensation, and Allowances to be made to Persons in re-
apeee: of their having held Civil Offices in his Majesty’s Ser-
vice,” so far as such provisions relate to officers and clerks who
had entered or might enter the public service subsequent to
the fourth day of August, One thousand eight hundred and
twenty-nine.
* See 16 & 17 Vict. c. 96, s, 39,
Lunacy act, 1845: 8 & 9 vicr. c. 100 303
6. And be it enacted, That every person hereby or here-
after appointed a’ Commissioner under this Act shall, before he
acts in the execution of his duty as a Commissioner, take an
oath to the following effect : (that is to say),
“YT, A. B.,doswear, That I will discreetly, impartially, and
faithfully execute.all the trusts and powers committed unto
me by virtue of an Act of Parliament made inthe ninth year
of the reign of her Majesty Queen Victoria, intituled [here
insert the title of the Act]; and that I will keep secret all such
matters as shall come to my knowledge in the execution of
my office (except when required to divulge the same by legal
authority, or so faras I shall feel myself called upon to do so
for the better execution of the duty imposed on me by the
said Act).
So help me GOD.”
Which oath it shall be lawful for the Lord Chancellor to
administer to every such Commissioner; and any three of the
Commissioners who shall have previously taken the oath are
hereby authorised to administer such oath to any other Com-
missioner.
7. And be it enacted, That the Commissioners shall cause
to be made a Seal of the Commission, and shall cause to be
sealed or stamped therewith all licences, orders, and instru-
ments granted or made, or issued, or authorised by the Com-
missioners, in pursuance of this Act, except such orders or
instruments as are hereinafter required or directed to be given
or signed and sealed by one Commissioner or two Com-
missioners; and all such licences, orders, and instruments,
or copies thereof, purporting to be sealed or stamped with the
Seal of the Commission, shall be received as evidence of the
same respectively, and of the same respectively having’ been
granted, made, issued, or authorised by the Commissioners,
without any further proof thereof; and no such licence,
order, or instrument, or copy thereof, shall be valid, or have
any force or effect, unless the same shall be so sealed or
stamped as sferesaid.
8. And be it enacted, That the Commissioners or any five
of them shall, as scon as may be after the passing of this Act,
meet at the ustal office or place of business now occupied or
used by the Metropolitan Commissioners in Lunacy, or at such
other place as the Lord Chancellor shall direct, and elect one’
Commis-
sioners to
take the
following
oath.
Commis-
sioners,
to have a
Common
Commis-
sioners
to elect a
permanent
chairman.
Appoint-
ment of
Secretary.
304 | MANUAL OF LUNACY
of the same Commissioners (not being a physician or a barrister
receiving any salary by virtue of this Act) to be the permanent
chairman of the Commission; and in case such permanent
chairman, or any other permanent chairman who shall there-
after be elected in pursuance of this provision, shall die, or
decline or become incapable to act as chairman, or shall cease
to be a Commissioner, then and as often as the same shall
happen the Commissioners for the time being, or any five of
them, at any meeting to be specially summoned for that pur-
pose, shall elect another person to be the permanent chairman
of the Commission in the place of the chairman who shall so
die, or decline or become incapable to act, or cease to be a
Commissioner as aforesaid ; and in case the permanent chair-
man for the time being shall be absent from any meeting it
shall be lawful for the majority of the Commissioners present
at any such meeting to elect a chairman for that meeting ; and
in all cases every question shall be decided by a majority of
voters (the chairman, whether permanent or temporary, having
a vote), and in the event of an equality of votes the chairman
for the time being shall have an additional or casting vote.
9. And be it enacted, That Robert Wilfred Skeffington
Lutwidge,* of Lincoln’s Inn, Esquire, shall be the secretary
to the Commissioners; and that the said Robert Wilfred Skef-
fington Lutwidge; and every secretary to be hereafter appointed,
shall be removeable from his office by the Lord Chancellor, on
the application of the Commissioners; and that as often as the
said Robert Wilfred Skeffington Lutwidge, or any secretary to
be appointed under this present provision, shall die, or resign,
or be removed. from his office, the Commissioners, with the
approbation of the Lord Chancellor, shall appoint a person to
be secretary in the room of the said Robert Wilfred Skeffing-
ton Lutwidge, or other the secretary who shall die, or resign,
or be removed as aforesaid ; and that the secretary for the time
being shall, in the performance of all his duties and in all re-
spects, be subject to the inspection, direction, and control of
the Commissioners; and that there shall be paid to the secre-
tary for the time being, out of the moneys and funds hereinafter
mentioned, the yearly salary of eight hundred pounds, by four
equal quarterly payments, on the twenty-ninth day of Septem-
* Mr. Lutwidge was subsequently appointed as one of the Com-
missioners in Lunacy; he was killed by a lunatic during the
present year, and succeeded by Hon, G. Howard.
LUNACY ACT, 1845: 8 & 9 viet. c. 100 305
ber, the twenty-fifth day of December, the twenty-fifth day of
March, and the twenty-fourth day of June in every year, the
first of such payments (or a proportionate part thereof, to be
computed, in the case of the said Robert Wilfred Skeffington
Lutwidge, from the passing of this Act, and in case of every
‘other secretary from the time of his appointment) to be made
to the said Robert Wilfred Skeffington Lutwidge on such of
the same days, of payment as shall first happen after the pass-
ing of this Act, and to every other secretary for the time being
on such of the same days of peyment as shall first happen
after his appointment.
10. And be it enacted, That any superannuation allowance
to be granted to any secretary appointed or to be appointed
under this Act shall be granted only in respect of services per-
formed under this Act, and shall be subject to the provisions
of an Act passed in the fourth and fifth years of his late Ma-
jesty King William the Fourth; intituled “An Act to alter,
amend, and consolidate the Laws for regulating the Pensions,
Compensation, and Allowances to be made to Persons in re-
spect of their having held Civil Offices in His Majesty’s Ser-
vice,”.so far as such provisions relate to officers and clerks who
had entered or might enter the public service subsequent to
the fourth day of August, One thousand eight hundred and
twenty-nine.
11. And be it enacted, That it shall be lawful for the
Commissioners to appoint, during pleasure, any two persons as
clerks to the Commissioners, and to allow to such two clerks
any such yearly or other salaries (not exceeding in the whole
the yearly sum of two hundred pounds for such two clerks)
as the Commissioners shall think proper; and further, that it
shall be lawful for the Commissioners, at any time hereafter, in
case they shall find it expedient so to do, for the due performance
of the business of the Commission, with the consent of the
Lord High Treasurer, or of the Commissioners of her Majesty’s
Treasury, or of any three or more of them, to appoint one or
two other clerks (in addition to the two clerks firstly herein-
before mentioned), and to allow to such one or two additional
clerk or clerks any such yearly or other salaries as the Com-
missioners shall think fit (not exceeding in the whole the
yearly sum of two hundred pounds); and such salaries shall
be paid out of the moneys or funds hereinafter mentioned.
12, And be it enacted, That every person appointed to be
x
Provision
for retiring
pension to
Secretary.
4&5 W.4.
Power for
the Com-
missioners
to appoint
two clerks.
306 MANUAL OF LUNACY
Secretary secretary or clerk as aforesaid shall, before he shall act as such
and clerks secretary or clerk, take the following oath, to be administered
an oath. by any one of the Commissioners :—
“T, A. B., do swear, That T will faithfully.execute all such
trusts and duties as shall be committed to my charge as
secretary to the Commissioners in Lunacy [or as clerk to the
Commissioners in Lunacy, as the case may be]; and that I will
keep secret all such matters as shall come to my knowledge in
the execution of my office (except when required to divulge
the same by legal authority).
“So help me GOD.”
Clerk of the 13. And be it enacted, That immediately after the passing
tees of this Act the clerk to the Metropolitan Commissioners in
Commis- Lunacy appointed under the said Act of the second and third
sioners to
deliver all years of the reign of his late Majesty King William the
owe Fourth, or under any of the other Acts hereby repealed, shall
Commis- forthwith deliver up every book, paper, and «document, and all
sloners e * . . .
under this §00ds, property, and effects which may be in his possession by
Act. virtue of his said office, or in consequence thereof, or connected
with the business thereof, to the Commissioners in Lunacy
hereby appointed ; and every book, paper, and document, and
all goods, property, and effects respectively, which shall be so
delivered unto or shall hereafter come into the possession of
the Commissioners in Lunacy by virtue of their office, shall
thereupon be vested in and shall be deemed to be the property
of the Commissioners in Lunacy for the time being.
Jurisdiction 14. And be it enacted, That it shall be lawful for the
a Com. Commissioners (if and when they shall think fit) to grant a
Sennen licence to any person to keep a house for the reception of
licences, lunatics, or of any sex or class of lunatics, within the places
end termed following ; (that is to say) the cities of London and West-
somes minster, the county of Middlesex, the borough of Southwark,
defined. ’ and the several parishes and places hereinafter mentioned ;
(that is to say,) Brixton, Battersea, Barnes, Saint Mary Mag-
* dalen Bermondsey, Christ Church Clapham, Saint Giles
Camberwell, Dulwich, Saint Paul Deptford, Gravenay, Kew
Green, Kennington, Saint Mary Lambeth, Mortlake, Merton,
Mitcham, Saint Mary Newington, Norwood, Putney, Peckham,
Saint Mary Rotherhithe, Roehampton, Streatham, Stockwell,
Tooting, Wimbledon, Wandsworth, and Walworth, in the
county of Surrey ; Blackheath, Charlton, Deptford, Greenwich,
LUNACY act, 1845: 8 & 9 vicr. c. 100 307
Lewisham, Lee, Southend, and Woolwich, in the county of
Kent; and East Ham, Layton, Laytonstone, Low Layton,
Plaistow, West Ham, and Walthamstow, in the county of
Fssex ; and also within every other place (if any) within the
distance of seven miles from any part of the said cities of
London or Westminster, or of the said borough of Southwark ;
all which cities, county, borough, parishes, and places afore-
said shall be and are hereafter referred to as the immediate
jurisdiction of the Commissioners.
15. And be it enacted, That the Commissioners or some
five of them shall meet at the usual office or place of business
-which shall for the time being be occupied or used by the
said Commissioners, or at such other place as the Lord
Chancellor may direct, on the first Wednesday in the months
of February, May, July, and November in every year, in order
to receive applications from persons requiring houses to be
licensed for the reception of lunatics within the immediate
jurisdiction of the Commissioners, and (if they shall think fit)
to license the same; and in case on any such occasion five
Commissioners shall not be present the meeting shall take
place on the next succeeding Wednesday, and so on weekly
until five Commissioners shall be assembled; and the Com-
missioners assembled at every such meeting shall have power
to adjourn such meeting from time to time and to such place
as they shall see fit: Provided always, nevertheless, that it
shall be lawful for any five of the Commissioners at any other
time, at any meeting duly.summoned under the provisions in
that behalf hereinafter contained, to receive applications from
persons requiring houses to be licensed as aforesaid, and, if
they shall think fit, to license the same. :
16. And be it enacted, That when and so often as any
Commissioner shall by writing under his hand require the
secretary to convene a meeting of the Commissioners for a
purpose or purposes specified in such writing, or for the
general despatch of business, such secretary is hereby re=
quired to convene such meeting by summons to the other
Commissioners, or such of them as shall be then in England
and shall have an address known to the secretary, and to give
them, as far as circumstances will admit, not less than twenty-
four hours’ notice of the place, day, and hour, where and on
and at which such meeting is intended to be held, and also to
state in the summons the purpose or purposes of such meeting,
x2
Commis-
sioners
to hold
quarterly
and special
meetings
for granting
licences,
Provision for
summoning
Special
meetings.
The Justices
of the Peace
in general
or quarter
sessions in
all other
parts of
England to
license
houses for
the reception
of lunatics,
and to
appoint
visitors,
For appoint-
ment of a
visitor in
the place of
‘one dying,
being un-
able, dis-
qualified, &c,
Lists of
visitors to
be published
th
by the
Clerk of the
Peace in a
newspaper,
and to be
sent to the
Commis-
sioners.
308 MANUAL OF LUNACY
as specified by the Commissioner requiring the same to be
convened; and then and in every such case it shall be lawful
for any three of the Commissioners to assemble themselves to
consider, and (if they shall think fit) to execute the purpose or
purposes of such meeting: Provided always, nevertheless, that
nothing shall be done at any such meeting, at which less than |
five Commissioners shall be present, which by this Act is
required to be done by five Commissioners :* Provided also, that
every such meeting shall, as far as circumstances will admit,
beheld at the usual office or place of business of the Com-
missioners.
17. And be it enacted, That in all places not being within
the immediate jurisdiction of the Commissioners the justices
for the county or borough assembled in general or quarter
sessions shall have the same authority within their respective
counties or boroughs to license houses for the reception of luna-
tics as the Commissioners within their immediate jurisdiction ;
and that the said justices shall, at the Michaelmas general or
quarter sessions in every year, appoint three or more justices,
and also one physician, suryeon, or apothecary, or more, to act
as visitors of every or any house or houses licensed for the
reception of lunatics within the said counties or boroughs
respectively ; and such visitors shall at their first meeting take
the oath required by this Act to be taken by the Commissioners,
mutatis mutandis, such oath to be administered by a justice.
18. And be it enacted, That in case at any time of the
death, inability, disqualification, resignation, or refusal to act
of any person so appointed a visitor as aforesaid, it shall be
lawful for the justices of the county or borough, at any general
or quarter sessions, to appoint a visitor in the room of the per-
son who shall die, or be unable, or be disqualified, or resign,
or refuse to act as aforesaid.
19. And be it enacted, That a list of the names, places of
abode, occupations, or professions of all visitors appointed as
hereinbefore is directed shall, within fourteen days from the
date of their respective appointments, be published by the
Clerk of the Peace of the county or borough for which they
shall be respectively, appointed, in. some newspaper commonly
circulated within the same county or borough, and shall, within
three days from the date of their respective appointments, be
* See 16 & 17 Vict. c. 96, 8, 36.
LUNACY act, 1845: 8 & 9 vicr. c. 100 309
sent by the Clerk of the Peace to the Commissioners; and
every Clerk of the Peace making default in either of the
respects aforesaid shall for every such default forfeit a sum not
exceeding two pounds.
20, And be it enacted, That every such visitor as aforesaid,
being 4 physician, surgeon, or apothecary, shall be paid out of
the moneys or funds hereinafter mentioned for every day during
which he shall be employed in executing the duties of this Act
such sum as the justices of the county or borough shall in-
general or quarter sessions direct.
21, And be it enacted, That the Clerk of the Peace, or
some other person to be appointed by the justices for the
county or borough in general or quarter sessions, shall act as
clerk to the visitors so appointed as aforesaid, and such clerk
shall summon the visitors to meet at such time and place, for
the purpose of executing the duties of this Act, as the said
justices in general or quarter sessions shall appoint; and every
such appointment, summons, and meeting shall be made and
held as privately as may be, and in such manner that no pro-
prietor, superintendent, or person interested in or employed
about or connected with any house to be visited shall have
notice of such intended visitation; and such clerk to the
visitors shall, at their first meeting, take the oath required by
this Act to be taken by the Secretary of the Commissioners,
mutatis mutandis, such oath to be administered by one of the
visitors, being a justice; and the name, place of abode, occu-
pation, and profession of the clerk to the visitors (whether the
same shall be the Clerk of the Peace or any other person)
shall within fourteen days after the appointment be published
by the Clerk of the Peace for the county or borough in some
newspaper commonly circulated therein, and within three
days from the date of the appointment be communicated by
the said Clerk of the Peace to the Commissioners; and every
Clerk of the Peace making default in either of the respects
aforesaid shall for every such default forfeit a sum not ex-
ceeding two pounds; and every such clerk to the visitors shall
be allowed such salary or remuneration for his services (to be
paid out of the moneys or funds hereinafter mentioned) as the
justices for the county or borough shall in general or quarter
sessions direct.
22, And be it enacted, That if the clerk of any visitors
shall at any time desire to employ an assistant in the execution
Penalty for
default.
Every
visitor, being
@ physician,
surgeon, or
apothecary,
to be remu-
nerated.
Clerk of the
Peace, or
some other
person, to Le
appointed
to be clerk
to visitors.
Oath of
clerk.
See § 6.
Remunera-
tion of clerk
to visitors,
Provision
for assistanta
to the clerk
of the
visitors.
Oath of
assistant,
Persons
interested in
any licensed
house, or’
being medi-
cal attend-
ant on any
patient
therein, .
disqualified
to act as
Commis-
sioner,
Visitor,
Secretary,
Clerk, or
Assistant,
310 ‘ MANUAL OF LUNACY
of the duties of his office, such clerk shall certify such desire.
and the name of such assistant to one of the visitors, being a,
justice ; and if such visitor shall approve thereof he shall
administer the following oath to such assistant :—
“T, A. B., do solemnly swear, That I will faithfully keep
secret all such matters and things as shall come to my know-
ledge in consequence of my employment as assistant to the
clerk of the visitors appointed for the county [or borough] of
by virtue of an Act of Parliament passed in the
ninth year of the reign of her Majesty Queen Victoria, inti-
tuled [here insert the title of the Act], unless required to
divulge the same by legal authority. “So help me GOD.”
And such clerk may thereafter, at his own cost, employ such’
assistant.
23, And be it enacted,.That mo person shall be or act as
a Commissioner, or visitor, or secretary, or clerk to the Com-.
missioners, or clerk or assistant clerk to any visitors, or act in
granting any licence, who shall then be, or shall within one
year then next preceding have been, directly or indirectly
interested in any house licensed for the reception of lunatics,
or the profits of such reception ; and no physician or surgeon
(being a Commissioner), and no physician, surgeon, or apothe-
cary (being a visitor), shall sign any certificate for the ad-
mission of any patient into any licensed house or hospital,*
or shall professionally attend upon any patient in’ any licensed
house cr hospital, unless he be directed to visit such patient
by the person upon whose order such patient has been re-
ceived into such licensed house or hospital, or by the Lord
“Chancellor, or her Majesty’s Principal Secretary of State for
the time being for the Home Department, or by a committee -- -
appointed by the Lord Chancellor; and if any, such Commis-
sioner, or visitor, or secretary, or clerk to the Commissioners,
or clerk or assistant clerk to any visitors, shall after his appoint-
ment be or become so interested in any house licensed for the
reception of lunatics, or the profits of such reception, such
Commissioner, visitor, secretary, or clerk, or assistant clerk, as
the case may be, shall immediately thereupon be disqualified
from acting and shall cease to act in such capacity ; and if any
person, being disqualified as aforesaid, shall take the office of Com-
* Vide 25 & 26 Vict. c. 111, s. 24.
Lunacy act, 1845: 8 & 9 vicr. c. 100 311
missioner, visitor, secretary, clerk, or assistant clerk, or being a
Commissioner, visitor, secretary, clerk, or assistant clerk, shall
become disqualified as aforesaid, and shall afterwards continue
to act in such capacity, such person shall be guilty of a misde-
meanour; and if any physician or surgeon (being a Commis-
sioner), or any physician, surgeon, or apothecary (being a
visitor), shall sign any certificate for the admission of any
patient into any licensed house or hospital, or shall profession-
ally attend any patient in any licensed house or hospital (ex-
cept as aforesaid), such physician, surgeon, or apothecary (as
the case may be) shall for each offence against this provision
forfeit the sum of ten pounds.
24, And be it enacted, That every person* who shall de-
sire to have a house licensed for the reception of lunatics shall
give a notice, if such house be situate within the immediate
jurisdiction of the Commissioners, to the Commissioners; and
if elsewhere, to the Clerk of the Peace for the’ county or bo-
rough in which such house is situate, fourteen clear_days at
the least prior to some quarterly or other meeting of the Com-
missioners, or to some general or quarter sessions for such
county or borough, as the case may be; and such notice shall
contain the true Christian and surname, place of abode, and
occupation of the person to whom the licence is desired to be
granted, and a true and full description of his estate or interest
in such house; and in case the person to whom the licence is
desired to be granted does not propose to reside himself in the
licensed house, the true Christian and surname and occupation
of the superintendent who is to reside therein; and such
notice, when given for any house which shall not have been
previously licensed, shall be accompanied by a plant of such
‘house, to be drawn upon a scale of not less than one-eighth of
an inch io-a foot, with a description of the situation thereof,
and the length, breadth, and height of and a reference by a
figure or letter to, every room and apartment therein, and a
statement of the quantity of land, not covered by any building,
annexed to such house, and appropriated to the exclusive use,
exercise, and recreation of the patients proposed to be received
therein, and also a statement of the number of patients proposed
to be received into such house, and whether the licence so ap-
* Vide 16 & 17 Vict. c. 96, ss. 1, 2.
+ Vide 16 & 17 Vict. c. 96, 8. 1, and 25 & 26 Vict. c, 111, 8, 14,
Disqualified
persons
acting a mis-
demeanour.
Physicians,
&c., contra-
vening,
penalty 102.
Fourteen
days’ pre-
vious notice
of intended
application.
for and
plan of
licensed
houze to be
given to
the Com-
missioners
or Clerk of
the Peace,
Notice of all
additions
and altera-.
tions to
be given to
the Com-
missioners
or Clerk of
the Peace,
Unirue
statement
a misde-
meanour.
A copy of
every licence
granted by
Justices to
be sent to
the Com-
missioners,
312 MANUAL OF LUNACY
plied for is for the reception of male or female patients, or of
both ; and if for the reception of both, of the number of each
sex proposed to be received into such house, and of the means
by which the one sex may be kept distinct and apart from the
other; and such notice, plan, aad statement, when sent to the
Clerk of the Peace, shall be laid by him before the justices of
the county or borough at such time as they shall take into
their consideration the application for such licence: * Provided
always, that it shall be lawful for any person to whom a
licence shall be granted to remove the superintendent named
in the notice, and at any time or times to appoint another
superintendent, upon giving a notice containing the true
Christian and surname and occupation of the new superin-
tendent to the Commissioners or the visitors of the house,
as the case may require: Provided always, that all plans
heretofore delivered shall be deemed sufficient for the pur-
poses of this Act, if the Commissioners or justices, as the case
may be, shall so think fit.
* 26, And be it enacted, That no addition or alteration shall
be made to, in, or about any licensed house, or the appur-
.tenances, unless previous notice in writing of such prcposed
addition or alteration, accompanied with a plan of such addi-
tion or alteration, to be drawn upon the scale aforesaid, and to
be accompanied by such description as aforesaid,} shall have
been given by the person to whom the licence shall have been
granted to the Commissioners or to the Clerk of the Peace, as
the case may be, and the consent in writing of the Commis-
sioners, or of two of the visitors, as the case may be, shall
have been previously given.
27, And be it enacted, That if any person shall wilfully
give an untrue or incorrect notice, plan, statement, or descrip-
tion of any of the things hereinbefore required to be included
in any notice, plan, or statement, he shall be guilty of a mis-
demeanour.
28, And be it enacted, That in every case in which a
licence for the reception of lunatics shall after the passing of
this Act be granted by auy justices, the Clerk of the Peace for
the county or borough shall, within fourteen days after such
licence shall have been granted, send a copy thereof ‘to the
* Sec. 25 is repealed by 16 & 17 Vict. ¢. 96, s. 1.
tT Vide 25 & 26 Vict. ec. 111, 5. 18.
Lunacy: act, 1845: 8 & 9 vict. c. 100 313
Commissioners; and any Clerk of the Peace omitting to send
such copy within such time shall for every such omission forfeit
a sum not exceeding two pounds.
29, And be it enacted, That in every case in which any
person shall apply for the renewal of a licence already granted
or hereafter to be granted, such person, if applying to the
Commissioners, shall with such application transmit to the
Commissioners, and if applying to any justices * shall with such
application transmit to the Clerk of the Peace for the county or
borough, and also at the same time to the Commissioners, a
statement signed by the person so applying, containing the
names and number of the patients of-each or either sex then
detained in such house, and distinguishing whether such
patients respectively are private or pauper patients; and any
person who shall hereafter obtain the renewal of a licence
without making such return or returns shall for every such
offence forfeit the sum of ten pounds ; and any person who shall
make any such return untruly shall be guilty of amisdemeanour.
80. And be it enacted, That every licence shall, as nearly
as conveniently may be, be according 1o the form in the Sche-
dule (A.) annexed to this Act,t and shall be stamped with a
ten shilling stamp, and shall be under the seal of the Commis-
sioners, if granted by them, and if by any justices under the
hands and seals of three or more such justices in general or
quarter sessions assembled, and shall be granted for such
period, not exceeding thirteen calendar months, as the Com-
missioners or justices, as the case may be, shall think fit.
81. And be it enacted, That no licence shall be granted or
visitor or clerk appointed by the justices for any borough with-
out the consent in writing of the Recorder of such berough to
such grant or appointment.
32. And be it enacted, That for every licence to be here-
after granted there shall be ‘paid to the Secretary of the Com-
missioners, or to the Clerk of the Peace, according as the licence
shall be granted by the Commissioners or justices (exclusive
of the sum to be paid for the stamp) the sum of ten shillings
and no more for every patient not being a pauper, and the sum
of two shillings and sixpence and no more for every patient
* Vide 25 & 26 Vict. c. 111, 5. 36.
+ Vide Schedule (A) annexed to Act 25 & 26 Vict. c. 111, and
x. 14 of that Act.
Every person
applying
for the
renewal of
a licence to
furnish a
statement
of the
number and
class of
patients then
detained.
Licences to
be made out
in a given
form, &c.,
and to be
for not
more than
thirteen
months.
No licence,
&c., in any
borough
without con-
sent of Re-
- corder.
Charge for
licences to be
granted in
pursuance of
this Act.
Power to re-
duce the
charge for
the licencein
certain
. cases.
Application
of moneys
received for
licences by.
thesecretary
of the
Ccmmis-
‘sioners.
Secretary of
the Commis-
sioners to
make out an
annual
account, to
be laid before
the Lords
Commis-
sioners of
the Trea-
sury, of all
receipts and
payments by
him under
this Act.
Balance of
payments
over receipts
may be paid
out of the
Consolidated
Fund.
314 1 MANUAL OF LUNACY :
being a pauper, proposed to be received into such house, and if
the total amount of such sums of ten shillings and two shil-
lings and sixpence shall not amount to fifteen pounds, then so
much more as shall make up the sum of fifteen pounds; and
no such licence shall be delivered until the sum payable for.
the same shall be paid: Provided always, that if the period for
which a licence shall be granted be less than thirteen calendar
months it shall be lawful for the Commissioners or the justices,
as the case may be, to reduce the payment to be made on such’
licence to any sum not less than five pounds.
33. And be it enacted, That all moneys received for licences
granted by the Commissioners, and for searches made in pur-
suance of the provision for that purpose hereinafter contained,
shall be retained by the Secretary of the Commissioners, and
be applied by him in or towards the payment of the salaries
and travelling and other expenses of the Commissioners and of
their secretary and clerks, and in or towards the payment or
discharge of all or any costs, charges, and expenses incurred by
or under the authority of the Commissioners in the execution
of or under or by virtue of this Act.
34, And be it enacted, That the Secretary of the Commis-
sioners shall make out an account of all moneys received and
paid by him as aforesaid, and of all moneys otherwise received
and paid by him, and of all charges and expenses incurred
under or by virtue of or in the execution of this Act; and such
account shall be made up to the first day of August in each
year, and shall be signed by five at least of the Commissioners;
and such account shall specify the several heads of charge and
expenditure, and shall be transmitted to the Lord High Trea-
surer, or to the Commissioners of her Majesty’s Treasury, who
shall thereupon audit such account, and, if he or they shall
deem it expedient, direct the balance (if any) remaining in the
hands of the said secretary to be paid into the Exchequer to
the account of the Consolidated Fund; and such accounts shall
be laid before Parliament on cr before the twenty-fifth day of
March in each year, if Parliament be then sitting, or if Parlia-
ment be not then sitting, then within one month after the then
next sitting of Parliament.
35. And be it enacted, That it shall be lawful for the Lord
High Treasurer, or the Commissioners of her Majesty’s*Trea-
sury, or any three or more of them, and they are hereby directed
and empowered, from time to time (on an application to them,
LUNACY acT, 1845: 8 & 9 vicr. c. 100 315
agreed to at some quarterly or other meeting of the Commis-
sioners, attended by five at least of the Commissioners, and
certified under their hands) to cause to be issued and paid out
of the Consolidated Fund to the Secretary of the Commis-
sioners such a sum of money as the Commissioners shall in
such application have certified to be requisite to pay and dis-
charge so much of the salaries, costs, charges, and expenses
hereinbefore directed to be paid out of the moneys received by
the said secretary for licences and otherwise as aforesaid as
such moneys shall be inadequate to pay, and the said secretary
shall thereupon apply such money in or towards the payment
or discharge of such salaries, costs, charges, and expenses re-
spectively ; and that it shall be lawful for the Lord High Trea-
surer or the Commissioners of her Majesty’s Treasury, or any
three or more of them, from time to time to advance by way of
imprest to the said secretary such sum or sums of money as to
such Lord High Treasurer or Commissioners of her Majesty’s
Treasury may appear requisite and reasonable, for or towards
the payment or discharge of all or any such salaries, costs,
charges, or expenses as aforesaid, such sum or sums to be
accounted for by the said secretary in his then next account.
36. And be it enacted, That all moneys to be received for
licences granted by any justices shall be applied by the Clerk of
the Peace for the county or borough in or towards the payment
of the salary or remuneration of the clerk to the visitors for
such county or borough, and in or towards the remuneration of
such of the same visitors as are hereinbefore directed to be
remunerated, and in or towards the payment or discharge of all
costs, charges, and expenses incurred by or under the authority
of the same justices or visitors in the execution of or under or
by virtue of this Act.
37. And be it enacted, That the Clerk of the Peace for
every county or borough shall keep an account of all moneys
received and paid by him as aforesaid, and of all moneys other-
wise received or paid by him under or by virtue of or in the
execution of this Act; and such account shall respectively be
made up to the first day of August in each year, and shall be
signed by two at least of the visitors for the county or borough ;
and every such account shall be laid by the Clerk of the Peace
before the justices at the Michaelmas general or quarter ses-
sions, who shall thereupon direct the balance (if any) remaining
in the hands of the Clerk of the Peace to he paid into the
Application
of moneys
received for
licences by
Clerks of the
Peace.
‘Clerks of the
Peace to
make out
annual ac-
counts, to be
laid before
the justices
in session, of
all receipts
and pay-
ments made
under this
Act.
Balance of
payments
over receipts
may be paid
out of the
funds of the
county or
borough,
Provision in
case of the
incapacity
or death of
the person
licensed.
316 MANUAL OF LUNACY
hands of the treasurer for such county or borough, in aid and
as part of the county or borough rate.
38. And be it enacted, That it shall be lawful for the jus-
tices for any county or borough in general or quarter sessions
assembled, if they shall think fit, to order to be paid to the
Clerk of the Peace of such county or borough, out of the rates
or funds thereof, such sum or sums of money as they shall, on
examination, deem to be necessary to pay and discharge so
much of the salary, remuneration, costs, charges, and expenses
hereinbefore directed to be paid out of the moneys received by
such Clerk of the Peace for licences and otherwise as aforesaid
as such moneys shall be inadequate to pay; and also that it
shall be lawful for the justices in general or quarter sessions
assembled, if they shall think fit, from time to time to order
to be advanced out of the rates or funds of such county or
borough, to the Clerk of the Peace, such sum or sums of money
as to such justices may appear requisite and reasonable, for or
towards the payment or discharge of any such salary, remunera-
tion, costs, charges, or expenses as last aforesaid; and every
such sum of money as aforesaid shall be paid and advanced _
out of the rates or funds of such county or borough by the
treasurer thereof, and shall be allowed in his accounts, on the
authority of the aforesaid order by the justices for the payment
or advance thereof.
39. And be it enacted, That if any person to whom a
licence shall have been granted under this Act or under any of
the Acts hereinbefore repealed shall by sickness or other suffi-
cient reason become incapable of keeping the licensed house,
or shall die before the expiration of the licence, it shall be law-
ful for the Commissioners or for any three justices for the
county or borough, as the case may be, if they shall respec-
tively think fit, by writing endorsed on such licence, under the
seal of the Commissioners or under the hands of such three
justices, to transfer the said licence, with all the privileges and
cbligations annexed thereto, for the term then unexpired, to
such person as shall at the time of such incapacity or death be
the superintendent of such house, or have the care of the
patients therein, or to such other person as the Commissioners
or such justices respectively shall approve, and in the meantime
such licence shall remain in force and have the same effect as
if granted to the superintendent of the house; and in case a
licence has been or shall be granted-to two or more persons
LUNACY act, 1845: 8 & 9 vicr. c. 100 317
and before the expiration thereof any or either of such persons
shall die, leaving the other or others surviving, such licence
shall remain in force and have the same effect as if granted to
such survivors or survivor.* ;
40. And be it enacted, That if any licensed house shall be
pulled down or occupied under the provisions of any Act of
Parliament, or shall by fire, tempest, or other accident be ren-
dered unfit for the accommodation of lunatics, or if the person
keeping such house shall desire to transfer the patients to
another house, it shall be lawful for the Commissioners (if the
new house shall be within their immediate jurisdiction), at
any quarterly or other meeting, or for any two or more of the
visiting justices for the county or borough within which the
new house is situate, as the case may be, upon the payment to
the Secretary of the Commissioners or the Clerk of the Peace,
as the case may be, of not less than one pound for the licence
(exclusive of the sum to be paid for the stamp), to grant to
the person whose house has been so pulled down, occupied, or
so rendered unfit, or who shall desire to transfer his patients as
aforesaid, a licence to keep such other house for the reception
- of lunatics, for such time as the Commissioners or the said
justices, as the case may be, shall think fit: Provided always,
that the same notice of such intended change of house, and the
same plans and statements and descriptions of and as to such
intended new house, shall be'given as are required when appli-
cation is first made for a licence for any house,t and shall be
accompanied by a statement in writing of the cause of such
change of house; and that, except in cases in which the
change of house is occasioned by fire or tempest, seven clear
days’ previous notice of the intended removal shall be sent, by
the person to whom the licence for keeping the original house
shall have been granted, to the person who signed the order
for the reception of each patient, not being a pauper, or the
person by whom the last payment on account of such patient
shall have been made, and to the relieving officer or overseer
of the union or parish to which each patient being a pauper is
chargeable, or the person by whom the last payment on account
of such patient shall have been made. :
41, And be it enacted, That if a majority of the justices of
* Vide 16 & 17 Vict. c. 96, ss. 1, 2,
+ Vide 16 & 17 Vict. c. 96, 8. 1.
Provision in
ease of a
licensed
house being
taken for
public pur-
poses, or ac-
cidentally
rendered
unfit, or of
the keeper
wishing to
transfer his
patients toa
new house.
Power of
revocation
of licences
granted by
justices.
Power of
revocation
and of prohi-
bition of
renewal of
licences
granted by
the Commis-
sioners or by
justices,
318 MANUAL OF LUNACY
any county or borough in general or quarter sessions assembled
shall recommend to the Lord Chancellor that any licence
granted by the justices for such county or borough, either before
or after the passing of this Act, shall be revoked, it shall be
lawful for the Lord Chancellor to revoke the same by an instru-
ment under his hand and seal, such revocation to take effect at
a period to be named in such instrument, not exceeding two
calendar months from the time a copy or notice thereof shall
have been published in the “ London Gazette ;” and a copy or
notice of such instrument of revocation shall be published in
the “ London Gazette,” and shall before such publication be
transmitted to the person to whom such licence shall have
been granted, or to the resident superintendent of the licensed
house, or be left at the licensed house: Provided always,
that in case of any such revocation being recommended to the
Lord Chancellor, notice thereof in writing shall, seven clear
days previously to the transmission of such recommendation to
the Lord Chancellor, be given to the person the revocation of
whose licence shall be recommended, or to the resident super-
intendent of the licensed house, or shall be left at the licensed
house.
42, And be it enacted, That if the Commissioners shall re-
commend to the Lord Chancellor that any licence granted either
by the Commissioners or by any justices, either before or after
the passing of this Act, shall be revoked or shall not be re-
newed, it shall be lawful for the Lord Chancellor by an instru-
ment under his hand and seal to revoke or prohibit the renewal
of such licence ; and in the case of a revocation the same shall
take effect at a period to be named in such instrument, not ex-
ceeding two calendar months from the time a copy or notice
thereof shall have been published in the. “ London Gazette ;”
and a copy or notice of such instrument of revocation shall be
published in the “ London Gazette,” and shall before such pub«
lication be transmitted to the person to whom such licence
shall have been granted, or to the resident superintendent of
the licensed house, or shall be left at the licensed house:
Provided always, that in case of any such revocation or prohi-
bition to renew being recommended to the Lord Chancellor, no-
tice thereof in writing shall, seven clear days previously to the
transmission of such recommendation to the Lord Chancellor, be
given to the person the revocation or prohibition of renewal of
whose licence shall be recommended, or to the resident super-
Lunacy act, 1845: 8 & 9 vicr. c. 100 319
intendent of the licensed house, or shall be left at the licensed
house.
43, And be it enacted, That the regulations * as to lunatics
of every hospital in which lunatics are or shall be received
shall be printed, and complete copies thereof shall be sent to
the Commissioners, and also kept hung up in the visitors’ room
of such hospital; and that every such hospital shall have a
physician, surgeon, or apothecary resident therein, as the super-
- intendent and medical attendant thereof; + and such superin-
tendent shall, immediately after the passing of this Act (or
immediately after the establishment of such hospital, as the
case may be), apply to the Commissioners to have such hos-
pital registered, and thereupon such hospital shall be registered
in a book to be kept for that purpose by the Commissioners ;
and in case the superintendent of any such hospital shall at
any time omit to have copies of such regulations sent or hung
up as aforesaid, or to apply to have such hospital registered as
aforesaid, he shall for every such omission forfeit a sum not
exceeding twenty pounds.
44, And be it enacted, That after the passing of this Act it
shall not be lawful for any person to receive two or more luna-
tics into any house, unless such house shall be an asylum or
an hospital registered under this Act, or a house for the time
being duly licensed under this Act, or one of the Acts herein-
before repealed ; and any person who shall receive two or more
lunatics into any house other than a house for the time being
duly licensed as aforesaid, or an asylum or an hospital duly
registered under this Act, shall be guilty of a misdemean-
our,
$50. And be it enacted, That every proprietor or superin-
tendent who shall receive any patient into any licensed house
or any hospital shall, within two days after reception of such
patient, make an entry with respect to such patient in a book
to be kept for that purpose to be called “The Book of Ad-
missions,” according to the form and containing the particulars
required in Schedule (E) annexed to this Act, so far as he can
ascertain the same, except as to the form of the mental dis-
order, and except also as to the discharge or death of the
* Vide 16 & 17 Vict. c. 96, s. 30.
ft Vide 16 &17 Vict. c. 96, s. 36.
t Ss. 45, 46, 47, 48, 49 are all repealed by 16 & 17 Vict. c. 96,
8. 3,
Hospitals re-
ceiving luna-
tics to have
their regula-
tions
printed,
and a resi-
dent medical
attendant,
and to be
registered.
No house to
be kept for
the recep-
tion of two
or more
lunatics
without a
licence.
Every person
receiving a
person as &
Innatic into
any house or
hospital to
make an
entry thereof
in a certain
form.
Form of
patient’sdis-
order to be
entered in
“The Book
of Admis-
sions” by
the medical
attendant.
Every person
receiving a
patient into
any house or
hospital to
transmit a
notice there-
of to the
Commis-
sioners, and
if within the
jurisdiction
of any visi-
tors, then
also to the
clerk of such
visitors.
Notices to be
given in case
of the escape
of any pa-
tient, and of
his being
brought
back.
320 MANUAL OF LUNACY
patient, which shall be made when the same shall happen ; and
every person who shall so receive any such patient, and shall
not within two days thereafter make such entry as aforesaid
(except as aforesaid), shall forfeit a sum not exceeding two
pounds ; and every person who shall knowingly and willingly
in any such entry untruly set forth any of the particulars shall
be guilty of a misdemeanour.
51, And be it enacted, That the form of the mental dis-
order of every patient received into any licensed house or any
‘hospital shall, within seven days after his reception, be entered
in the said Book of Admissions by the medical attendant of
such house or hospital; and every such medical attendant wha
shall omit to make any such entry within the time aforesaid
shall for every such offence forfeit a sum not exceeding two
pounds.
52, And be it enacted, That the proprietor or resident su-
perintendent of every licensed house (whether licensed by the
Commissioners or by any justices), and the superintendent of
every hospital, shall after two clear days, and before the expi-
ration of seven clear duys* from the day on which any patient
shall have been received into such house or hospital, transmit
a copy of the order and medical certificates or certificate on
which such person shall have been received, aud also a notice
and statement according to the form in Schedule (F) annexed
to this Act, to the Commissioners ; and the proprietor or resi-
dent superintendent of every house licensed within the juris-
diction of any visitors shall also within the same period trans-
mit another copy of such order and certificates or certificate,
and a duplicate of such notice and statement, to the clerk of
the visitors; and every proprietor or superintendent of any
such house or hospital who shall neglect to transmit such
copy, notice, or statement to the Commissioners, or (where
the same is required) to the clerk of the visitors, shall be guilty
of a misdemeanour.
53. And be it enacted, That whenever any patient shall
escape from any licensed house or any registered hospital the
proprietor or superintendent of such house or hospital shall,
within two clear days next after such escape, transmit a written
notice thereof to the Commissioners; and if such house be
* Vide 25 & 26 Vict.c. 111,s. 28. By this it is seen that the
medical certificates must now be forwarded within twenty-four
hours from patient’s admission.
Lunacy act, 1845: 8 & 9 vicr. c. 100 321
within the jurisdiction of any visitors, then also to the clerk of
such visitors; and such notice shall state the Christian and sur-
name of the patient who has so escaped, and his then state of
mind, and also the circumstances connected with such escape ;
and if such patient shall be brought back to such house or‘hos-
pital,* such proprietor or resident superintendent shall, within
two clear days next after such person shall be so brought back,
transmit a written notice thereof to the Commissioners; and
also, if such house be within the jurisdiction of any visitors,
to the clerk of such visitors; and such notice shall state when
such person was so brought back, and the circumstances con-
nected therewith, and whether with or without a fresh order
and certificates or certificate ; and every proprietor or resident
superintendent omitting to transmit such notice, whether of
escape or of return, shall for every such omission forfeit a sum
not exceeding ten pounds.
54, And be it enacted, That whenever any patient shall be
removed or discharged from any licensed house or any hospital,
or shall die therein, the proprietor or superintendent of such
house or hospital shall, within two clear days next after such
removal, discharge, or death, make an entry thereof in a book
to be kept for that purpose according to the form and stating
the particulars in Schedule (G1) annexed to this Act, and
shall also within the same two days transmit a written noticet
thereof, and also of the cause of his death, to the Commissioners,
and also, if such house shall be within the jurisdiction of any
visitors, to the clerk of such visitors, according to the form and
containing the particulars in Schedule (G 2) annexed to this
Act; and every proprietor or superintendent of any such house
or hospital’ who shall neglect to make such entry or transmit
such notice or notices, or shall therein set forth any thing
untruly, shall be guilty of a misdemeanour.
55, And be it enacted, That in case of the death of any
patient in any licensed house or any hospital, a statement of
the cause of the death of such patient, with the name of any
person present at the death, shall be drawn up and signed by
the medical attendant of such house or hospital, and a copy
thereof, duly certified by the proprietor or superintendent of
such house or hospital, shall by him be transmitted to the
Commissioners, and also to the person. signing the order for
* Vide 25 & 26 Vict. c. 111; 8. 39.
f Vide 16 & 17 Vict. c. 96, 5. 19. + Ibid,
XY
Entry to be
made, and
notice given,
incase of the
death, dis-
charge, or
removal of
any patient.
In case of
the death of
a patient, a
statement of
the cause of
death to be
transmitted
to the Com-
missioners,
and, if with-
in the juris-
diction of
any visitors,
to the clerk
of the visit-
ors also.
Abuse or
ill-treatment
of neglect of
a patient to
be treated as
a misde-
meanour,
Houses hav-
ing 100 pa-
tients to .
have a, resi-
dent medical
attendant,
and houses
having less
to be visited
by a medical
attendant.
322 MANUAL OF LUNACY
such patient’s confinement, and to the registrar of deaths for
the district, and if such house be within the jurisdiction of
any visitors, then also to the clerk of such visitors, within
forty-eight hours after the death of such patient; and every
medical attendant, proprietor, or superintendent who shall
neglect or omit to draw up, sign, certify, or transmit such
statement .as aforesaid shall for every such neglect or omission
forfeit and pay a sum not exceeding fifty pounds.
56, And be it enacted, That if any superintendent, officer,
nurse, attendant, servant, or other person employed in any
licensed house or registered hospital shall in any way abuse or
ill-treat any patient contined therein, or shall wilfully neglect
any such patient, he shall be deemed guilty of a misdemeanour ;*
and that in the event of the release of any person from con-
finement in any asylum or private house who shall consider
himself to have been unjustly confined, a copy of the certi-
ficates and order upon which he has been confined shall at his
request be furnished to him or to his attorney by the clerk to
the Commissioners, without any fee or reward for the same;
and it shall be lawful for the Home Secretary, on the report
of the Commissioners or yisitors of any asylums, to direct her
Majesty’s Attorney-General to prosecute on the part of the
Crown any person who shall have been concerned in the
unlawful taking or confinement of any of her Majesty's subjects
as an insane patient, and likewise any person who shall have
been concerned in the neglect or ill-treatment of any patient
or person so confined.
57. And be it enacted, That in every house licensed for
one hundred patients or more there shall be a physician,
surgeon, or apothecary resident as the superintendent or
‘ medical attendant thereof; and that every house licensed for
less than one hundred and more than fifty patients (in case
such house shall not be kept by or have a resident physician,
surgeon, or apothecary +) shall be visited daily by a physician,
surgeon, or apothecary ; and that every house licensed for less
than fifty patients (in case such house shall not be kept by or
have a resident physician, surgeon, or apothecary) shall be
visited twice in every week by a physician, surgeon, or apothe-
* Vide 16 & 17 Vict. c. 96, ss. 9, 26.
f Vide 25 & 26 Vict. c. 111, 8.47. The medical attendant must
be registered under the Medical Act,
Lunacy act, 1845: 8 & 9 vier. oc. 100 323
cary: Provided always, that it shall be lawful for the visitors
of any licensed house to direct that such house, and for the
Commissioners to direct that any licensed house, shall be
visited by a physician, surgeon, or apothecary at any other
time or times, not being oftener than once in every day.
58. Provided always, and be it enacted, That when any
house is licensed to receive less than eleven lunatics it shall be
lawful for any two of the Commissioners or any two of the
visitors of such house, if they shall respectively so think fit,
by any writing under their hands, to permit that such house
shall be visited by a physician, surgeon, or apothecary at such
intervals more distant than twice in every week as such Com-
missioners or visitors shall appoint, but not at a greater
interval than once in every two weeks.
59. And be it enacted, That every physician, surgeon, or
apothecary, where there shall be only one, keeping or residing
in or visiting any licensed house or any hospital, and where
there shall be two or more physicians, surgeons, or apothecaries
keeping or residing in or visiting ary licensed house or any
hospital, then one at least of such physicians, surgeons, or
apothecaries shall once in every week (or, in the case of any
house at which visits at more distant intervals than once a
week are permitted, on every visit) enter and sign in a book
to be kept at such house or hospital for that purpose, to be
called “The Medical Visitation Book,” a report, showing the
date thereof, and also the number, sex, and state of health of
all the patients then in such house or hospital, the Christian
and surname of every patient who shall have been under
restraint or in seclusion, or under medical treatment, since
the date of the last preceding report, the condition of the
house or hospital, and every death, injury, and act of violence
which shall have happened to or affected any patient since the
then last preceding report, according to the form in Schedule*
(H) annexed to this Act; and every such physician, surgeon,
or apothecary who shall omit to enter or sign such report as
aforesaid shall for every such omission forfeit and pay the sum
of twenty pounds; and every such physician, surgeon, or
apothecary who shall in any such report as aforesaid enter
any thing untruly shall be guilty of a misdemeanour,
60. And be it enacted, That there shall be kept in every
licensed house and in every hospital a book to be called “The
* This form is altered. Vide 16 & 17 Vict. ¢, 96, 8. 25,
x2
The Com-
missioners
and visitors,
in houses
licensed for
less than 11
persons, may
lessen the
number of
medical
visits.
A book to be
Kept, to be
called “* The
Medical
Visitation
Book,” in
which a
weekly entry
is to be
made, show-
ing the con-
dition of the
house and of
the patients.
A medical
case book ta
be kept.
All licensed
houses and
hospitals to
be visited by
the Com-
missioners.
324 MANUAL OF LUNACY
Case Book,” in which the physician, surgeon, or apothecary
keeping or residing in or visiting such house or hospital shall
from time to time make entries of the mental state and bodily
condition of each patient, together with a correét description
of the medicine and other remedies prescribed for the treat-
ment of his disorder; and that it shall be lawful for the Com-
missioners from time to time, by any order under their common
seal, to direct the form in which such case book shall be kept
by such physician, surgeon, or apothecary; and immediately
after a copy of such order shall have been transmitted by the
Secretary of the Commissioners to such physician, surgeon, or
apothecary, such physician, surgeon, or apothecary shall there-
upon keep such case book in the form which shall be directed
by such order; and that it shall be lawful for the Commis-
sioners (whenever they shall see fit) to require, by an order in
writing under their common seal, such physician, surgeon, or
apothecary to transmit to the Commissioners a correct copy
of the entries or entry in any case book kept under the pro-
visions of this Act, relative to the case of any lunatic who is
or may have been confined in any such licensed house or hos-
pital; and every such physician, surgeon, or apothecary who
shall neglect to keep the said case book, or to keep the same
according to the form directed by the Commissioners, or to
transmit a copy of the said entry or entries, pursuant to such
order or orders as aforesaid, shall for every such neglect forfeit
any sum not exceeding ten pounds.
61. And be it enacted, That every * licensed house shall,
without any previous notice, be visited by two at least of the
Commissioners (one of whom shall be a physician or surgeon,
and the other a barrister) four times at the least in every year,
if such house shall be within the immediate jurisdiction of the
Commissioners, and if not, twice at least in every year; and
every t hospital in which lunatics shall be received shall, with-
out any previous notice, be visited by two at least of the said
Commissioners (one of whom shall be a physician or surgeon,
and the other a barrister) once at least in every year; and
every such visit shall be made on such day or days, and at
such hours of the day, and for such length of time, as the
visiting Commissioners shall think fit, and also at such other
* Vide 25 & 26 Viet. c. 111, s. 29.
t Vide 25 & 26 Vict.c. 111, s, 30,
LUNACY act, 1845: 8 & 9 vicr. c. 100 325
times (if any) as the said Commissioners in Lunacy shall
direct; and such visiting Commissioners, when visiting such
house or hospital, may and shall inspect every part of such
house or hospital, and every outhouse, place, and building’
communicating with such house or hospital, or detached there-
from, but not separated by ground belonging to any other
person, and every part of the ground or appurtenances held,
used, or occupied therewith, and see every patient then con-
fined in such house or hospital, and inquire whether any
patient is under restraint, and why, and inspect the order and
certificates or certificate for the reception of every patient who
shall have been received into such house or hospital since the
last visit of the Commissioners, and in the case of any house
licensed by justices shall consider the observations made in
the Visitors’ Book for such house by the visitors appointed by
the justices, and enter in the Visitors’ Book of such house or
hospital a minute of the then condition of the house or hos-
pital, and of the patients therein, and the number of patients
under restraint, with the reasons thereof, as stated, and such
irregularity (if any) as may exist in any such order or certifi-
cates aforesaid, and also whether the previous suggestions (if
any) of the visiting Commissioners or visitors have or have not
been attended to, and any observations which they may deem
proper as to any of the matters aforesaid or otherwise, and
also, if such visit be the first after the granting a licence to the.
house, shall examine such licence, and, if the same be in con-
formity with the provisions of this Act, sign the same, but if it
be informal, enter in such Visitors’ Book in what respect such
licence is informal: Provided also, that it shall be lawful for
the Lord Chancellor, on a representation by the Commissioners
setting forth the expediency of such alteration, by any writing
under his hand, to direct that any house licensed by justices
shall (during such period as he shall therein specify, or until
such his direction shall be revoked) be visited by the Com-
missioners once only in the year, and also to direct that any
house licensed by the Commissioners, and not receiving any
pauper patients therein, shall (during such period as he shall
therein specify, or until such his direction shall be revoked)
be visited by the Commissioners twice only in the year.
62. And be it enacted, That every licensed house within
the jurisdiction of any visitors appointed by justices shall be
visited by two at least of the said visitors (one of whom shall
Licensed
houses not
within the
immediate
jorisdiction
of the Com-
missioners to
be inspected
four times a
year at least
by the
visitors.
The proprie-
tors or su-
perintendent
of every
house and
hospital to
show every
part and
every pa-
tient to the
visiting
Commis-
sioners and
visitors.
326 MANUAL OF LUNACY
be a physician, surgeon, or apothecary) four times at the least
in every year, on such days, and at such hours in the day, and
for such length of’ time as the said visitors shall think fit, and
also at such other times (if any) as the justices by whom such
house shall have been licensed shall direct; and such visitors
when visiting any such house may and shall inspect every
part of such house, and every house, outhouse, place, and
building communicating therewith, or detached therefrom, but
not separated by ground belonging to any other person, and
every part of the ground or appurtenances held, used, or occu-
pied therewith, and see every patient then confined therein, and
inquire whether any patient is under restraint, and why, and
inspect the order and certificates or certificate for the recep-
tion of every patient who shall have been received into such
house since the last visit of the visitors, and enter in the Visi-
tors’ Book a minute of the then condition of the house, of the
patients therein, and the number of patients under restraint,
with the reasons thereof as stated, and such irregularity (if
any) as may exist in any such order or certificates as afore-
said, and also whether the previous suggestions (if any) of
the visitors or visiting Commissioners have or have not been
attended to, and any observations which they may deem
proper as to any of the matters aforesaid or otherwise.
63. And be it enacted, That the proprietor or superin-
tendent of every licensed house or hospital shall show to the
Commissioners and visitors * respectively visiting the same every
part thereof respectively, and every person detained therein
as a lunatic ; and every proprietor or superintendent of any
licensed house or any hospital who shall conceal or attempt to
conceal, or shall refuse or wilfully neglect to show, any part of
such house or hospital, or any house, outhouse, place, or building
communicating therewith, or detached therefrom, but not sepa-
rated as aforesaid, or any part of the ground or appurtenances
held, used, or occupied therewith, or any person detained or
being therein, from any visiting Commissioners or visitors, or
from any person authorised under any power or provision of
this Act to visit and inspect such house or hospital, or the
patients confined therein, or any of them, shall be guilty of a
misdemeanour.
64, And be it enacted, That the visiting Commissioners
* Vide 25 & 26 Vict. c. 111, ss. 29, 30.
LUNACY acT, 1845: 8 & 9 viet. c. 100 327
and visitors respectively, upon their several visitations to every
licensed house and to every hospital, shall inquire when
divine service is performed, and to what number of the
patients, and the effect thereof; and also what occupations or
amusements are provided for "the patients, and the result
thereof; and whether there has been adopted any system of
non-coercion, and if so, the result thereof; and also as to the
classification of patients; and also as to the condition of the
pauper patients (if any) when first received; and also as to
the dietary of the pauper patients (if any); and shall also
make such other inquiries as to such visiting Commissioners or
visitors shall seem expedient ;* and every proprietor or super-
intendent of a licensed house or an hospital who shall not
give full and true answers to the best of his knowledge to all
questions which the visiting Commissioners and visitors respec-
tively shall ask in reference to the matters aforesaid shall be
guilty of a misdemeanour.
65. And be it enacted, That upon every visit of the visiting
Commissioners to any licensed house or to any hospital, and
upon every visit of the visitors to any licensed house, there
shall be laid before such visiting Commissioners or visitors (as
the case may be), by the proprietor or superintendent of such
licensed house, or of such hospital, a list of all the patients
then in such house or hospital (distinguishing pauper patients
from other patients, and males from females, and specifying
such as are deemed curable), and also the several books by this
Act required to be kept by the proprietor or superintendent
and by the medical attendant of a licensed house or an hos-
pital, and also all orders and certificates relating to patients
admitted since the last visitation of the Commissioners or
visitors (as the case may be), and also, in the case of a licensed
house, the licence then in force for such house, and also all
such other orders, certificates, documents, and papers relating
to any of the patients at any time received into such licensed
house or hospital'as the visiting Commissioners or visitors
shall from time to time require to be produced to them; and
the said visiting Commissioners or visitors, as the case may be,
shall sign the said books as having been produced to them.
66, And be it enacted, That there shall be hung up in
some conspicuous part of every licensed house a copy of the
* Vide 25 & 26 Vict. ¢. 111, 8. 85."
Inquiries to
be made by
the Com-
missioners
and visitors
on their
several
visitations.
Books and
documents
to be pro-
duced to
visiting
Commis-
sioners and
visitors.
A book to be
kept called
“The Visit-
ors’ Book,’”*
for the re-
sult of in-
spection and
inquiries ;
and a book
called ‘‘ The
Patients’
Book,” for
observations
as to
state of
patients.
Proprietor
or resident
superinten-
dent to
transmit all
entries by
visitors and
visiting
Commis-
sioners to
the clerk of
the visitors
and to the
Commis-
sioners.
Commis-
sioners
visiting a
328 MANUAL OF LUNACY
plan given to the Commissioners or justices on applying for the
licence of such house; and that there shall be kept in every.
licensed house and in every hospital in which lunatics shall
be received a Queen’s Printer’s copy of this * Act, bound up in
a book to be called “ The Visitors’ Book ;” and that the said
visiting Commissioners and visitors respectively shall at the
time of their respective visitations enter therein the result of
the inspections and inquiries hereinbefore directed or authorised
to be made by them respectively, with such observations (if any)
as they shall think proper; and that there shall also be kept
in every such house and hospital a book to be called “The
Patients’ Book,” and that the said visiting Commissioners and
visitors respectively shall at the times of their respective
visitations enter therein such observations as they may think
fit respecting the state of mind or body of any patient in such
house or hospital.
67. And be it enacted, That the proprietor or resident
superintendent of every licensed house and of every hospital
shall, within three days after every such visit by the visiting
Commissioners + as aforesaid, transmit a true and perfect copy
of the entries made by them in “ The Visitors’ Book,” “The
Patients’ Book,” and “ The Medical Visitation Book,” respec-
tively (distinguishing the entries in the several books), to the
Commissioners, and shall, within three days after every such
visitation by the visitors, transmit a true and perfect copy of the
entries made by them as aforesaid (distinguishing as aforesaid).
to the Commissioners and also to the clerk of the visitors;
and the copies so transmitted to the clerk of the visitors of all
such entries relating to any licensed house, and made since the
grant or last renewal of the licence thereof, shall be laid before
the justices on taking into consideration the renewal of the
licence to the house to which such entries shall relate ;{ and
every such proprietor or superintendent as aforesaid who shall
omit to transmit, as hereinbefore directed, a true and perfect
copy of every or any such entry as aforesaid shall for every
such omission forfeit a sum not exceeding ten pounds.
68. And be it enacted, That the Commissioners visiting
any house licensed by justices shall carefully consider and
* Vide 16 & 17 Vict. c. 96, s. 37.
+ Vide 25 & 26 Vict. c. 111, ss. 29, 30.
¢ Vide 265 & 26 Vict. c. 111, 5. 36.
LUNACY acT, 1845: 8 & 9 vict. c. 100 329
give special attention to the state of mind of any patient house
therein confined, as to the propriety of whose detention they conse BY.
shall doubt (or as to whose sanity their attention shall be spe- ee
cially called), and shall, if they shall think that the state of Patients’
mind of such patient is doubtful, and that the propriety of his pee ee
detention requires further consideration, make and sign a er etd
minute thereof in the Patients’ Book of such house; and a patient, and
true and perfect copy of every such minute shall, within two paesaere tO
clear days after the same shall have been made, be sent by ine eee
the proprietor or superintendent of such house to the clerk who are ”
of the visitors of such house, and such clerk shall forthwith (PUSiPo"
communicate the same to the said visitors, or some two of Patient. -
them (of whom a physician, surgeon, or apothecary shall be
. one), and such visitors shall thereupon immediately visit such
patient, and act as they shall see fit; and every such proprietor
or superintendent who shall omit to send a true and perfect
copy, a8 hereinbefore directed, of every or any such last-
mentioned minute, and every clerk who shall neglect to
communicate the same to two of the visitors as aforesaid, shall
be guilty of a misdemeanour.
69. And be it enacted, That the visiting Commissioners. visiting
shall, after every visitation by them to every licensed house Commis:
not being within their immediate jurisdiction, and to every report on
hospital, report in writing the general result of their inspection oe MOE
thereof (together with such special circumstances, if any, as Peaieden
they may deem proper to notice) to the Commissioners; and and also on
the Secretary of the Commissioners shall thereupon enter the "*?***
same in a book to be kept for that purpose.
70, And be it enacted, That it shall be lawful for the Com- Power for
62 ‘ . the Com-
missioners, or any five of them, at any quarterly or special missioners,
meeting, by any resolution or resolutions under their common 0 2ny five.
seal, or to be entered ina book to be kept for that purpose, make rules,
aid signed by ‘five at least of the Commissioners present at
such meeting, from time to time to make such orders and
rules as they shall think fit for regulating the duties of the
Commissioners, or any of them, or of their secretary, clerks,
and servants, or for the due or better performance of the busi-.
ness of the Commission: Provided nevertheless, that the Secre-
tary of the Commissioners shall give to every Commissioner,
so far as circumstances will admit, not less than seven days’
\ notice of every such special meeting, and shall in the sum-
Power in
certain cases
to visit by
night.
The person
who signed
the order for
the recep-
tion of a
private
patient may
order his
discharge or
removal,
Provision
for the
discharge of
@ private
patient
when the
person who
signed the
order for his
reception is ,
incapable,
Mode of
removal or
discharge
of pauper
patients.
330 MANUAL OF LUNACY
mons for such special meeting state the purposes for which the
same is intended to be held.
71. And be it enacted, That it shall be lawful for any two
or more of the Gar ttesioners, or any two visitors, to visit and
to inspect any licensed house or hospital at such hour of the
night as they shall think fit: Provided nevertheless, that no
such visitor shall make any such visitation or inspection except
of a licensed house within their jurisdiction.
72. And be it enacted, That if and when any person who
signed the order on which any patient (not being a pauper)
was received into any licensed house or into any hospital shall
by writing under his hand direct that such patient shall be
discharged or removed, then and in such case such patient shall
forthwith be discharged or removed, as the person who signed
the order for his reception shall direct.*
73, And be it enacted, That if the person who signed the
order on which any patient (not being a pauper) was received
into any licensed house or into any hospital be incapable by
reason of insanity or absence from England, or otherwise, of
giving an order for the discharge or removal of such patient,
or if such person be dead, then and in any of such cases the
husband or wife of such patient, or if there be no such husband
or wife, the father of such patient, or if there be no father, the
mother of such patient, or if there be no mother, then any one
of the nearest of kin for the time being of such patient, or the
person who made the last payment on account of such patient,
may by any writing under his or her hand give such direction
as aforesaid for the discharge or removal of such patient, and
thereupon such patient shall be forthwith discharged or re-
moved as the person giving such direction shall direct.t
74, And be it enacted, That the guardians of any parish or
union may by a minute of their board, or an officiating clergy-
man of any parish not under a Board of Guardians, and one
of the overseers thereof, or any two justices of the county or
borough in which such last-mentioned parish is situate, may
by writing under the hands respectively of such clergyman and
overseer, or of such justices direct that any pauper patient be-
longing to such parish or union, and detained in any licensed
house or any hospital, shall be discharged or removed there-
* Vide 16 & 17 Vict. c. 96. 5s. 19, 20, and 25 & 26 Vict. ¢. 111,
5. 43, + Ibid.
LUNACY act, 1845: 8 & 9 vier. o. 100 331
from, and may direct the mode of such discharge or removal ;
and if a copy of such minute or such writing be produced to
the proprietor or superintendent of such licensed house or such
hospital, he shall forthwith discharge or remove such patient,
or cause or suffer such patient to be discharged or removed
accordingly.*
_ 7. Provided always, nevertheless, and be it enacted, That
no patient shall be discharged or removed, under any of the
powers hereinbefore contained, from any licensed house or any
hospital, if the physician, surgeon, or apothecary by whom the
same shall be kept, or who shall be the regular medical atten-
dant thereof, shall by writing under his hand certify that in his
opinion such patient is dangerous and unfit to be at large, to-
gether with the grounds on which such opinion is founded,
unless the Commissioners visiting such house or the visitors of
such house shall, after such certificate shall have been produced
to them, give their consent in writing that such patient shall
be discharged andremoved : Provided that nothing herein con-
tained shall prevent any patient from being transferred from
any licensed house or any hospital to any other licensed house
or any other hospital, or to any asylum, but in such case every
such patient shall be placed under the control of an attendantt
belonging to the licensed house, hospital, or asylum to or from
which he shall be about to be removed for the purpose of such
removal, and shall remain under such control until such time
as such removal shall be duly effected.
76. And be it enacted, That it shall be lawful for any two
or more of the Commissioners to make visits to any patient
detained in any house licensed by the Commissioners, on such
days and at such hours as they shall think fit; and if after two
distinct and separate visits so made (seven days at least to in-
tervene between such visits) it shall appear to such visiting
Commissioners that such patient is detained without sufficient
cause, it shall be lawful for the Commissioners, if they shall
think fit, to make such order as to the Commissioners shall
seem meet for the discharge of such patient, and such patient
shall be discharged accordingly.
77. And be it enacted, That it shall be lawful for any two
or more of the Commissioners, of whom one shall be a physi-
* Vide 16 & 17 Vict. c. 96, 8. 19.
+ Vide 16 & 17 Vict. c. 96, 8. 36,
No patient
to be
removed
under any
of the
preceding
powers,
if certified
to be
dangerous,
unless the
Commis-
sioners or
visitors
consent, or
for the pur-
pose of
transfer to
some other
asylum,
Commis-
sioners may
discharge
any patient
confined in
a house
licensed by
themselves.
Two Com-
missioners
may make
special visits
to discharge
any patient
confined in
a house
licensed by
justices orin
an hospital,
Similar
powers for
two visitors
as to houses
within their
jurisdiction.
Every order
for the
discharge
of a patient
under the
last pre-
ceding
powers to
be signed by
the persons
exercising
them, and
to be subject
to certain
restrictions.
The last
preceding
powers to
be exercised
under
certain other
restrictions,
332 MANUAL OF LUNACY
cian and one a barrister, to make special visits to any patient
detained in any house licensed by the justices, or in any hospi-
tal, on such days and at such hours as they shall think fit; and
if after two distinct and separate visits so made it shall appear
to such visiting Commissioners that such patient is detained
without sufficient cause, they may make such order ag to them
shall seem meet for the discharge of such patient, and such
patient shall be discharged accordingly.
78. And be it enacted, That it shall be lawful for any two
or more of the visitors of any licensed house, of whom one
shall be a physician, surgeon, or apothecary, to make special
visits to any patient detained in such house, on such days and
at such hours as they shall think fit; and if after two distinct
and separate visits so made it shall appear to such visitors that
such patient is detained without sufficient cause, they may
make such order as to them shall seem meet for the discharge
of such patient, and such patient shall be discharged accord-
ingly.
' 79. Provided always, and be it enacted, That every such
order by any Commissioners or visitors for the discharge of a
patient from any house licensed by justices, or from any
hospital, shall be signed by them, and that each of such
special visits shall be by the same Commissioners or visitors;
and that it shall not be lawful for such Commissioners or
visitors to order the discharge of any patient from any such
last-mentioned house or hospital without having previously,
if the medical attendant of such house or hospital shall have
tendered himself for that purpose, examined him as to his
opinion respecting the fitness of such patient to be discharged ;
and if such Commissioners or visitors shall, after so examining
such medical attendant discharge such patient, and such
medical attendant shall furnish them with any statement in
writing containing his reasons against the discharge of such
patient, they shall forthwith transmit such statement to the
Commissioners or to the clerk of the visitors, as the case may
require, to be kept and registered in a book for that purpose.
80. Provided also, and be it enacted, That not less than
seven days shall intervene between the first and second of such
special visits; and that such Commissioners or visitors shall,
seven days previously to the second of such special visits, give
notice thereof, either by post or by an entry in the Patients’
Book, to the proprietor or superintendent of the house
Lunacy act, 1845: 8 & 9 vict. c. 100 333
licensed by justices or of the hospital in which the patient
intended to be visited is detained; and that such proprietor
or superintendent shall forthwith, if possible, transmit by post
a copy of such notice, in the case of a patient not being a
pauper, to the person by whose authority such patient was
received into such house, or by whom the last payment on
account of such patient was made, and in the case of a pauper,
to the guardians of his parish or union, or if there be no such
guardians, to one of the overseers for the time being of his
parish, and also in the case of any patient detained in a house
licensed by justices, to the clerk of the visitors of such house.
81. Provided always, nevertheless, and be it enacted, That
none of the powers of discharge hereinbefore contained shall
extend to any person who shall have been found lunatic by
inquisition or under any inquiry directed by the Lord Chan-
cellor, in pursuance of the powers in that behalf hereinafter
given to him, nor to any lunatic confined under any order or
authority of her Majesty’s Principal Secretary of State for the
Home Department, or under the order of any court of criminal
jurisdiction.
82. And be it enacted, That it shall be lawful for the
visitors of any licensed house at -any time to determine and
regulate the dietary of the pauper patients therein; and that
it shall be lawful for the visiting Commissioners at any time
to determine and regulate the dietary of the pauper patients
in any licensed house or in any hospital; and that if such
determination and regulation of any visitors and of the visiting
Commissioners shall not agree with each other, then the de-
termination and regulation of the visiting Commissioners shall
be followed: Provided always, nevertheless, that every such
regulation shall be made to take effect only from such time
as not to affect any contract existing on the first day of June
last for the maintenance of pauper patients before the first day
of June One thousand eight hundred and forty-six, or the
expiration of such contract, whichever shall first happen.
83. And be it enacted, That if any person shall apply to
any visitor in order to be informed whether any particular
person is confined in any licensed house within the jurisdiction
of such visitor, the said visitor, if he shall think it reasonable
to permit such inquiry to be made, shall sign an order to the
clerk of the visitors, and the said clerk shall, on receipt of
such order, and on payment to him of a sum not exceeding
Preceding
powers not
to extend
to persons
found.luna-
tie by
inquisition,
or confined
under
authority
of Secretary
of State. -
Power for
visitors and
visiting
Commis-
sioners to
regulate the
dietary of
pauper
patients.
Power for
any visitors
to give an
order or the
clerk of the
visitors to
search and
give infor-
mation, )
Power for
any Com-
missioner
to give an
order to the
Secretary of
the Com-
missioners
to search
and give
information
whether any
particular
person is or
has been
within
twelve
months con-
fined in any
house or
hospital,
Any one
Commis-
sioner or
334 MANUAL OF LUNACY
seven shillings for his trouble, make search amongst the
returns made to him in pursuance of this Act whether the
person inquired after is or has been within the then last twelve
calendar months confined in any licensed house within the
jurisdiction of such visitor; and if it shall appear that such
person is or has been so confined, the said clerk shall deliver
to the person so applying a statement in writing, specifying
the situation of the house in which the person so inquired
after appears to be or to have been confined, and of the name of
the proprietor or resident superintendent thereof, and also the
date of the admission of such person into such licensed house,
and (in case of his having been removed or discharged) the
date of his removal or discharge therefrom.
84. And be it enacted, That if any person shall apply to
any Commissioner in order to be informed whether any par-
ticular person is confined in any licensed house, or in any
hospital, asylum, or other place by this Act made subject to
the visitation of the Commissioners, such Commissioner, if he
shall think it reasonable to permit such inquiry to be made,
shall sign an order to the Secretary of the Commissioners, and
the secretary shall, on the receipt of such order, and on pay-
ment to him of a sum not exceeding seven shillings (to be
applied as hereinbefore provided), make search amongst the
returns made in pursuance of this Act, or of any of the Acts
hereby repealed, whether the person inquired after is or has
been within the last twelve calendar months confined in any
house, hospital, asylum, or place by this Act made subject to
the visitation of the Commissioners; and ‘if it shall appear that
such person is or has been so confined, the secretary shall
deliver to the person so applying a statement in writing,
specifying the situation of the house, hospital, asylum, or
place in which the person so inquired after appears to be or to
have been confined, and also (so far as the said secretary can
ascertain the same from any register or return in his possession)
the name of the proprietor, superintendent, or principal officer
of such house, hospital, asylum, or place, and also the date of
the admission of such person into such licensed house, hospital,’
asylum, or other place, and (in case of his having been re-
moved or discharged) the date of his removal or discharge
therefrom.
85. And be it enacted, That it shall be lawful for any one
of the Commissioners, as to patients confined in any house,
é
LUNACY act, 1845: 8 & 9 vicr. c. 100 335
hospital, or other place (not being a gaol) hereby authorised
to be visited by the Commissioners, and also for any one of the
visitors of any licensed house, as to patients confined in such
‘house, at any time to give an order in writing under the hand
of such one Commissioner or visitor for the admission to any
patient of any relation or friend of such patient (or of any
medical or other person whom any relation or friend of such
patient shall desire to be admitted to him), and such order of
admission may be either for a single admission, or for an
admission for any limited number of times, or for admission
generally at all reasonable times, and either with or without
any restriction as to such admission or admissions being in the
presence of a keeper or not, or otherwise ; and if the proprietor
or superintendent of any such house, hospital, or place shall
refuse admission to, or shall prevent or obstruct the admission
to any patient of, any relation, friend, or other person who
shall produce such order of admission as aforesaid, he shall for
every such refusal, prevention, or obstruction forfeit a sum not
exceeding twenty pounds.
86. And be it enacted, That it shall be lawful for the pro-
prietor or superintendent of any licensed house or of any hospital,
with the consent in writing of any two of the Commissioners,
or in the case of a house licensed by justices, of any two of the
visitors of such house, to send or take, under proper control,
any patient to any specified place for any definite time for the
benefit of his health: * Provided always, nevertheless, that
before any such consent as aforesaid shall be given by any
Commissioners or visitors the approval in writing of the
person who signed the order for the reception of such patient,
or by whom the last payment on account of such patient was
made, shall be produced to such Commissioners or visitors,
unless they shall, on cause being shown, dispense with the
game.
87. And be it enacted, That in every case in which any
patient shall, under any of the powers or provisions of this
Act, be removed temporarily from the house or hospital into
which the order for his reception was given,t or be trans-
ferred from such house or hospital into any new house, and
also in every case in which any patient shall escape from any
house or hospital, and shall be retaken within fourteen days
* Vide 25 & 26 Vict. c. 111, 5, 38.
visitor may
give an
order for the
admission to
any patient
of any friend
or relation,
or any per-
son named
by a friend
or relation,
Proprietor
or superin-
tendent,
with consent
of two Com-
missioners
or visitors,
may take or
send a
patient to
any place
for his
health,
In case of
the removal
of a patient,
or of his
escape and
recapture)
within
fourteen
days, the
original
order for his
reception to
remain in,
force,
Commission-
ers to report
to the Lord
Chancellor
periodically.
Constitution
of the pri-
vate com-
" mittee.
No person
(except a
person de-
riving no
profit, or a
committee)
to take
charge of a
single luna-
tic, except
upon such
order and
medical
certificates
as aforesaid,
336 MANUAL OF LUNACY
next after such escape,* the certificate or certificates relating
to and the original order for the reception of such patient
shall respectively remain in force, in the same manner as the
same would have done if such patient had not been so re-
moved or transferred, or had not 80 escaped and been retaken.
88. And be it enacted, That the Commissioners shall, at the
expiration of every six calendar months, report to the Lord
Chancellor the number of visits which they shall have made,
the number of patients whom they shall have seen, and the
number of miles which they shall have travelled during such
months, and shall on the first day of January in each year
make a return to the Lord Chancellor of all sums received by
them for travelling expenses, or upon any other and what
account, and shall also in the month of Junet in every year
make to the Lord Chancellor a report of the state and condi-
tion of the several houses, hospitals, asylums, and other places
visited by them under this Act, and of the care of the patients
therein, and of such other particulars as they shall think de-
serving of notice; and a true copy of such reports, showing the
number of visits made, the number of patients seen, and the
number of miles travelled, and also a copy of such return of
sums received for travelling expenses, or on any other and
what account, shall be laid before Parliament within twenty-
one days next after the commencement of every Session of
Parliament.
89. And be it enacted, That the permanent chairman for
the time being of the Commissioners, and two other of the
Commissioners to be appointed by the Lord Chancellor from
time to time as occasion may require (one of whom shall be a
physician or surgeon, and the other a barrister), shall be a
committee, to be called “the private committee,” for the pur-
poses hereinafter mentioned.j
90. And be it enacted, That no person (unless he be a
person who derives no profit from the charge, or a committee
appointed by the Lord Chancellor) shall receive to board or
lodge in any house, other than an hospital registered under
this Act, or an asylum, or a house licensed under this Act, or
under one of the Acts hereinbefore repealed, or take the care
=
* Vide 25 & 26 Vict. c. 111, s. 39.
t Vide 16 & 17 Vict. c. 96, 5. 32.
¢ Repealed by 16 & 17 Vict. c. 96, 8, 27.
pred
Lunacy act, 1845: 8 & 9 vicr. c. 100 337
or charge of any one patient as a: lunatic or alleged lunatic,
without the like order and medical certificates in respect of
such patient as are hereinbefore required on the reception of a
patient (not being a pauper) into a licensed* house; and that
and under
certain obli-
gations.
every person (except a person deriving no profit from the charge, .
ora committee appointed by the Lord Chancellor) who shall
receive to board or lodge in any unlicensed house, not being a
registered hospital or an asylum, or take the care or charge
of any one patient as a lunatic or alleged lunatic, shall, within
seven clear days after so-receiving or taking such patient,t
transmit to the Secretary of the Commissioners a true and per-
fect copy of the order and medical certificates on which such
patient has been so received, and a statement of the date of
such reception, and of the situation of the house into which
such patient has been received, and of the Christian and sur-
name and occupation of the occupier thereof, and of the person
by whom the care and charge of such patient has been taken ;f
and every such patient shall at least once in every two weeks§
be visited by a physician, surgeon, or apothecary not deriving,
and not having a partner, father, son, or brother who derives,
any profit from the care or charge of such patient ;|| and such
physician, surgeon, or apothecary shall enter in a book, to be
kept at the house or hospital for that purpose, to be called
“The Medical Visitation Book,” the date of each of his visits,
and a statement of the condition of the patient’s health, both
mental and bodily, and of the condition of the house in which
such patient is, and such book shall be produced to the visiting-
Commissioner on every visit, and shall be signed by him as
_ having been so produced ;** and the person by whom the care
or charge of such patiént has been taken, or into whose house
he has been received as aforesaid, shall transmit to the Secre-
tary of the Commissioners the same notices and statements of
* Vide 16 & 17 Vict. c. 96, s. 8, and 25 & 26 Vict. c. 111, s. 22.
“By this latter section it will be seen that lunatics found so by
inquisition can be received into asylums without medical certificates.
} Vide 25 & 26 Vict. c. 111, s. 28.
} Vide 25 & 26 Vict. c. 111, 5. 41.
§ Vide 16 & 17 Vict. c. 96,8. 14, and 25 & 26 Viet. ec. 111,
8, 22, relating to Chancery lunatics.
|| Vide 16 & 17 Vict. c. 96, 8. 14..
4 Vide 25 & 26 Vict. c. 111, 8. 42,
*¥* Vide 16 & 17 Vict. c. 96, 8. 16.
Z
Copy of the
lunatics re-
ceived into
an un-
licensed
house to be
entered in a
private
register,
Members of
the private
committee
to visit un-
licensed
houses
receiving a
single pa-
tient, and
report.
338 MANUAL OF LUNACY.
the death, removal, escape, and recapture of such lunatic, and
within the same periods, as are hereinbefore required in the case
of the death, removal, escape, and recapture of a patient (not
being a pauper) received into a licensed house ; * and that every
person who shall receive into an unlicensed house, not being a
registered hospital nor an asylum, or take the care or charge of
any person therein as a lunatic, without first having such order
and medical certificates as aforesaid, or who, having received
any such patient, shall not within the several periods aforesaid
transmit to the Secretary of the Commissioners such copy,
statement, and notices as aforesaid, or shall fail to cause such
patient to be so visited by a medical attendant as aforesaid, and
every such medical attendant who shall make an untrue entry
in the said Medical Visitation Book, shall be guilty of a mis-
demeanour.
91. And be it enacted, That the Secretary to the Commis-
sioners shall preserve every copy transmitted as aforesaid of
the order and certificates for the reception of any patient as a
lunatic into an unlicensed house, and every statement and
notice which may be transmitted to such secretary with respect
to any such patient as aforesaid, and shall enter the same (in
such form as the private committee shall direct) in a book to
be kept for that purpose, to be called “The Private Register,”
and such private register shall be kept by such- secretary in his
own custody, and shall be inspected only by the members for
the time being of the said private committee,t and by such
other persons as the Lord Chancellor shall by writing under
his hand appoint.
92. And be it enacted, That it shall be lawful for any one
member of the said private committee, on the direction of such
committee, or of any two members thereof (of whom the one
member aforesaid may be one), at all reasonable times to visit
every or any unlicensed house in which one patient only is
received as a lunatic (unless such patient be so received by a
person deriving no profit from the charge, or by a committee
appointed by the Lord Chancellor), and to inquiret and report
to the said private committee§ on the treatment and state of
* Vide 16 & 17 Vict. c. 96, ss. 17-21, 22. These refer to
discharge, change of residence, transfer of patient to care of another
person, and temporary absence.
T Vide 16 & 17 Vict. c. 96, s. 27.
{ Vide 25 & 26 Vict. c. 111, 8, 35.
§ Vide 16 & 17 Vict. c. 96, 8, 27.
LUNACY act, 1845: 8 & 9 vicr. c. 100 339
health, both bodily and mental, of such patient; and a copy of
every or any such report shall be entered in a private register,
to be kept for that purpose, by the Secretary of the Com-
missioners, and another copy thereof shall, if such private
committee think it expedient, be laid before the Lord Chan-
cellor.* :
93. And be it enacted, That it shall be lawful for the Lord
Chancellor, on the representation of the said private committe,
accompanied with a copy of a report made as Jast aforesaid as
to any patient received or detained as a lunatic in an unlicensed
house as aforesaid, to make an order that auch patient shall be
removed from such house, and from the care and charge of the
person under whose care and charge such lunatic may be; and
any person detaining such lunatic in such house, or in such
care or charge, for the space of three days after a copy of such
order shall have been left at such house or served on such
person, shall be guilty of a misdemeanour.f
94. And be it enacted, That whenever the Commissioners
shall have reason to suppose that the property of any person
detained or taken charge of as a lunatic is not duly protected,
or that the income thereof is not duly applied for his main-
tenance, such Commissioners shall make such inquiries relative
thereto as they shall think proper, and report thereon to the
Lord Chancellor.
95. And be it enacted, That when any person shall have
been received or taken charge of as a lunatic upon an order and
certificates, or an order and certificate, in pursuance of the pro-
visions of this Act, or of any Act hereinbefore repealed, and
shall either have been detained as a lunatic for the twelve
months then last past, or shall have been the subject of a report
by the Commissioners in pursuance of the provision lastly
hereinbefore contained, it shall be lawful for the Lord Chan-
cellor to direct that one of the said Masters in Lunacy shall,
and thereupon one of the said Masters shall, personally examine
such person, and shall take such evidence and call for such in-
formation as to such Master shall seem necessary to satisfy him
whether such person is a lunatic, and shall report thereon to
the Lord Chancellor, and such report shall be filed with the
* Vide 16 & 17 Vict. c. 96, 8. 15.
+ Vide 16 & 17 Vict. ¢. 96, 8. 18. ;
t Vide 16 & 17 Vict, ¢. 96, s. 28, and 25 & 26 Vict. . 111,
8, 35,
22
The Lord
Chancellor
on such
report, and
the repre-
sentation of
the private
committee,
may order a
lunatic to be
removed,
Commission-
ers to report
if property
of lunatics
be not duly
protected or
applied.
The Lord
Chancellor
to direct the
Master in
Lunacy to
report as to
the lunacy
of any per-
son detained
as a lunatic,
and to ap-
point guar-
dians of his
person and
estate, and
direct the
application
of his in-
come.
Masters in
Lunacy to
~ have all
necessary
powers of
inquiry, and
to make
inquiries
referred to
them,
340 MANUAL OF LUNACY
Secretary of Lunatics; and it shall be lawful for the Lord
Chancellor from time to time to make orders for the appoint-
ment of a guardian, or otherwise for the protection, care, and
management of the person of any person who shall by any such
report-as last aforesaid be found to be a lunatic, and such guar-
dian shall have the same powers and authorities as a com-
mittee of the person of a lunatic found such by inquisition now
has, and also to make orders for the appointment of a receiver,
or otherwise for the protection, care, and management of the
estate of such lunatic, and such receiver shall have the sama
powers and authorities as a receiver of the estate of a lunatic
found such by inquisition now has, and also to make orders
for the application of the income of such lunatic, or a sufficient
part thereof, for his maintenance and support, and in payment
_of the costs, charges, and expenses attending the protection,
care, and management of the person and estate of such lunatic,
and also as to the investment or other application for the pur-
pose of accumulation of the overplus, if any, of such income, for
the use of such lunatic, as to the Lord Chancellor shall from
time to time in each case seem fit: Provided always, that such
protection, care, and management shall continue only during
such time as such lunatic shall continue to be detained as a
lunatic upon an order and certificates or certificate as aforesaid,
and for such further time, not exceeding six months, as the
Lord Chancellor may fix: Provided also, that it shall be lawful
for the Lord Chancellor in any such case, either before or after
directing such inquiry by such Master as aforesaid, and whether
such Master shall have made a report as aforesaid or not, to
direct a commission in the nature of a writ de lunatico inqui-
rendo to issue, to inquire of the lunacy of such person.
96. And be it enacted, That such Masters shall have
power, in the prosecution of all inquiries and matters which
may be referred to them as aforesaid, or otherwise uhder this
Act, to summon persons before them, and to administer oaths,
and take evidence, either vivd voce or on affidavit, and to re-
quire the production of books, papers, accounts, and docu-
ments; and that the Lord Chancellor may by any order (either
general or particular) refer to the said Masters any inquiries
under the provisions of this Act relating to the person and
estate of any lunatic as to whom a report shall be made by a
Master as aforesaid, in like manner as inquiries relating to the
Lunacy act, 1845: 8 & 9 vicr. c. 100 341
persons and estates of lunatics found such by inquisition are
. now referred to them.
97. And be it enacted, That it shall be lawful for the
Lord Chancellor from time to time to make such orders as
shall to him seem fit for regulating the form and mode of pro-
ceeding before the Lord Chancellor and before the said Mas-
ters, and of any other proceedings pursuant to the provisions
‘of this Act, for the due protection, care, and management of
the persons and estates of lunatics as to whom such reports
shall be made by the said Masters as aforesaid, and also for
fixing, altering, and discontinuing the fees to be received and
taken in respect of such proceedings, as to the Lord Chan-
cellor shall from time to time seem fit: Provided neverthe-
less, that all fees to be so received and taken shall be paid into
the Bank of England, and placed to the credit of the Ac-
countant-General of the Court of Chancery, to the account
intituled “The Suitors’ Fee Fund Account,” in like manner
as and together with the fees payable under the Act passed in
the fifth and sixth years of her present Majesty, intituled
“An Act to alter and amend the Practice and Course of Pro-
‘ceeding under Commissions in the Nature of Writs De Luna-
tico Inquirendo,” and. be applied in like manner as such last-
mentioned fees.
98. And be it enacted, That the travelling and vier ex-
penses of the said Masters and their clerks shall be paid to
them, by virtue of any order or orders of the Court of Chancery, .
out of the said fund, intituled “The Suitors’ Fee Fund Ac-
count,” in the same manner as their expenses under the said
“last-mentioned Act.
~ 99. And be it enacted, That every proprietor and superin-
tendent of a licensed house or registered hospital, and every
other person hereby or by any of the Acts hereinbefore re-
pealed authorised to receive or take charge of a lunatic upon
an order, and who shall receive or has received a proper order,
in pursuance of this Act or any of the said repealed Acts,
accompanied with the required medical certificates or certifi-
cate, for the reception, or taking charge of any person as a
lunatic, and the assistants and servants of such proprietor,
superintendent, or other person, shall have power and autho-
rity to take charge of, receive, and detain such patient until he
shall die, or be removed or discharged by due authority ; and
in case of the escape at any time or times of such patient, to
Lord Chan-
cellor to
make orders
and regu-
lations, and
fix fees.
5 & 6 Vict.
c. 84,
Masters’
expenses
how to be
paid. —
Proprietors,
superin-
tendents,
and other
authorised
persons, may
plead the.
order and
certificates
for receiving
any lunatic
in bar of all
proceedings
at law.
Commission-
ers and
visitors may
summon
witnesses
to give
evidence,
with a
penalty for
non-com-
pliance.
Provision
for the pay-
ment of
witnesses’
expenses,
342 MANUAL OF LUNACY
retake him at any time within fourteen days after such escape,
and again to detain him as aforesaid ;* and in every writ, in-
dictment, information, action, and other proceeding which shall.
be preferred or brought against any such proprietor, superin-
tendent, or other person authorised as aforesaid, or against any
assistant or servant of any such proprietor, superintendent, or
authorised person, for taking, confining, detaining, or re-
taking any person as a lunatic, the party complained of may
plead such order and certificates or certificate in defence to
any such writ, indictment, information, action, or other pro-
ceeding as aforesaid ; and such order and certificates or certi-
-ficate shall, as respects such party, be a justification for
taking, confining, detaining, or retaking such lunatic or alleged
lunatic.
100. And be it enacted, That it shall be lawful for the
Commissioners, or any two of them, and also for the visitors
of any licensed house, or any two of such visitors, from time
to time, as they shall see occasion, to require, by summons f
under the common seal of the Commission, if by the Com-
missioners, and if by two only of the Commissioners, or by
two visitors, then under the hands and seals of such two
Commissioners or two visitors, as the case may be (according
to the form in Schedule (I) annexed to this Act, or as near
thereto as the case will permit), any person to appear before
them to testify on oath the truth touching any matters respect-
ing which such Commissioners and visitors respectively are by
this Act authorised to inquire (which oath such Commissioners
or visitors are hereby empowered to administer); and every
person who shall not appear before such Commissioners or
visitors pursuant to such summons, or shall not assign some
reasonable excuse for not so appearing, or shall appear and
refuse to be sworn or examined, shall, on being convicted
thereof before one of her Majesty's justices for the county or
borough within which the place at which such person shall.
have been by such summons required to‘ appear and give evi-
dence is situate, shall for every such neglect or refusal forfeit
@ sum not exceeding fifty pounds.
101. And be it enacted, That it shall be lawful for any
Commissioners or visitors who shall summon any person to
* Vide 25 & 26 Vict. ve. 111, 8. 39.
T Vide 25 & 26 Vict. c. 111, 5. 46.
LUNACY AacT, 1845: 8 & 9 vict. c. 100 343
appear and give evidence as aforesaid to direct the Secretary of
the Commissioners or the clerk of such visitors, as the case
may be, to pay to such person all reasonable expenses of his
appearance and attendance in pursuance of such summons, the
same to be considered as expenses incurred by such Commis-
sioners and visitors respectively in the execution of this Act,
and to be taken into account and paid accordingly.
102, And be it enacted, That every complaint or informa-
tion of or for any offence against this Act, where any pecu-
niary penalty is hereby imposed (except when hereby other-
-wise provided for), may be made before one justice ; and when
any person shall be charged upon oath before a justice for any
such offence against this Act, such justice may summon the
person charged to appear at a time and place to be named in
such summons; and if he shall not appear accordingly, and
upon proof of the due service of the summons (either per-
sonally or by leaving the same at his last or usual place of
abode) any two justices may either proceed to hear and deter-
mine the case, or may issue their warrant for apprehending
such person and bringing him before any two justices; and
any two justices shall and may, upon the appearing of such
person pursuant to such-summons, or upon such person being
apprehended with such warrant, or upon the non-appearance
of such person, hear the matter of every such complaint or
information, and make any such determination thereon as such
justices shall think proper; and upon conviction of any person
such justices may, if they shall think fit, reduce the amount
of the penalty by this Actimposed for such offence to any
sum not less than one-fourth of the amount thereof, and shall
and may issue a warrant under their hands and seals for
levying such penalty or reduced penalty, and all costs and
charges of such summons, warrant, and hearing, and all inci-
dental costs and charges, by distress and sale of the goods and
chattels of the person so convicted ; and it shall be lawful for
any such two justices to order any person so convicted to be
detained and kept in the custody of any constable or other
peace officer until return can be conveniently made to such
warrant of: distress, unless the said offender shall give security
to the satisfaction of such justices, by way of recognisance or
otherwise, for his appearance before such justices on such day
as shall be appointed for the return of such warrant of dis-
tress, such day not being more than seven days from the time
Upon com-
plaint made
of any
offence
against this
Act, justices
to require
the attend-
ance of the
person
charged, and
adjudicate
thereon.
Recovery of
penalties.
Committal
of offenderf
Application
of penalties.
Form of
conviction
before jus-
tices.
344 MANUAL OF LUNACY
of taking any such security; but if upon the return of: such
warrant of distress it shall appear that no sufficient distress
can be had whereupon to levy the said penalty, and such costs
and charges as aforesaid, and the same shall not be forthwith
paid; or in case it shall appear to the-satisfaction of such jus-
tices, either by the confession of the offender or otherwise, that
the offender hath not sufficient goods and chattels whereupon
the said penalty, costs, and charges may be levied, such jus-
tices shall and may, by warrant under their hands and seals,
commit such offender to the common gaol or house of cor-
rection for any term not exceeding three calendar months,
unless such penalty and all such costs and charges ag aforesaid
shall be sooner paid; and all such penalties, when recovered,
shall be paid, when the complaint or information shall be laid
or brought by or by the direction of the Commissioners, to the
‘Secretary of the Commissioners, to be by him applied and
accounted for as hereinbefore directed with respect to moneys
received for licences granted by the Commissioners; and when
the complaint or information shall be laid or brought by the
direction of any visitors, to the clerk of the peace for the county
or borough, to be by him applied and accounted for as herein-
before directed with respect to moneys received for licences
granted by the justices of such county or borough; and the
overplus (if any) arising from such distress and sale, after pay-
ment of the penalty and all costs and charges as aforesaid,
shall be paid, upon demand, to the owner of the goods and
chattels so distrained.
103. And be it enacted, That the justices before whom any
person shall be convicted of any offence against this Act for
which a pecuniary penalty is imposed may cause the conviction
to be drawn up in the following form, or in any other form to
the same effect, as the case may require; and that no conviction
under this Act shall be void through want of form :—
Bs it remembered, That on the day of
jin the year of our Lord : at
in the County [or Borough] of A. B. was convicted
before us of Her Majesty’s Justices of the
Peace for the said County [or Borough], for that he the said
did and we the said
adjudge the said
for his Offence to pay the Sum of
LUNACY act, 1845: 8 & 9 vior. co. 100 345
104, Provided always, and be it enacted, That any perscn
who shall think himself aggrieved by any order or determination
of any justices under this Act may, within four calendar
months after such order made or given, appeal to the justices
at general or quarter sessions, the person appealing having
first given at least fourteen clear days’ notice in writing of such
appeal, and the nature and matter thereof, to the person
appealed against, and forthwith after such notice entering into
a recognisance before some justice, with two sufficient sureties,
conditioned to try such appeal, and to abide the order and
award of the said Court thereupon; and the said justices at
general or quarter sessions, upon the proof of such notice and
recognisance having been given and entered into, shall in a
summary way hear and determine such appeal, or, if they
think proper, adjourn the hearing thereof until the next general
or quarter sessions, and, if they see cause, may mitigate any
penalty to not less than one fourth of the amount imposed by
this Act, and may order any money to be returned which shall
have been levied in pursuance of such order or determination,
and shall and may also award such further satisfaction to be
made to the party injured, or such custs to either of the par-
ties, as they shall judge reasonable aud proper; and all such
determinations of the said justices at general or quarter sessions
shall be final, binding, and conclusive upon all parties to all
* intents and purposes whatsoever.
105. And be it enacted, That if any action or suit shall be
brought against any person for any thing done in pursuance of
this Act or of any of the Acts hereby repealed, the same shall
be commenced within twelve calendar months next after the
release of the party bringing the action, and shall be laid or
brought in the county or borough where the cause of action
shall have arisen, and not elsewhere; and the defendant in
every such action or suit may, at his election, plead specially
or as to the general issue not guilty, and give this Act and the
special matter in evidence at any trial to be had thereupon,
and that the same was done in pursuance and hy the authority
of this Act; and if the same shall appear to be so done, or
that such action or suit shall be brought in any other county
or borough than as aforesaid, or shall not have been commenced
within the time-before limited for bringing the same, then the
jury shall find a verdict for the defendant; and upon a verdict
being so found, or if the plantiff shall be nonsuited, or discon-
Appeal to
Quarter
Sessions,
Actions to
be com-
menced
within
twelve
calendar
months.
Evidence
in support
of plea.
Offenders to
be prose-
cuted, and
penalties
sued for by
the Secre-
tary of the
Commission-
ers and the
clerk of any
visitors,
and by no
person with-
out the
authority of
the Com-
missioners
or visitors.
Offenders
against the
provisions
of any of
the repealed
Acts may be
prosecuted
under this
Act,
346 MANUAL OF LUNACY
tinue his action or suit after the defendant shall have appeared,
or if upon demurrer judgment shall be given against the
plaintiff, then the defendant shall recover double costs, and
have such remedy for recovering the same as any defendant
hath or may have in any other cases by law.
106. And be it enacted, That it shall be lawful for the
Secretary of the Commissioners, on their order, to prosecute
any person for any offence against the provisions of this Act,
and to sue for and recover any penalty to which any person is
made liable by this Act; and all penalties sued for and re-
covered by such secretary shall be paid to him, and be by him
applied and accounted for as hereinbefore directed with respect
to moneys received for licences granted by the Commissioners;
and that it shall be lawful for the clerk of any visitors, on their
order, to prosecute any person for any offence against the pro-
visions of this Act committed within the jurisdiction of. such
visitors, and to sue for and recover any penalty to which any
person within the jurisdiction of such visitors is made liable
by this Act; and all penalties sued for and recovered by any
such clerk shall be paid to him, und be by him paid to the
Clerk of the Peace for such county or borough, and be by such
Clerk of the Peace applied and accounted for as hereinbefore
directed with respect to moneys received for licences by such
Clerk of the Peace; and it shall not be lawful for any one to
prosecute any person for any offence against the provisions of’
this Act, or to sue for any penalty to which any person is made
liable by this Act, except by order of the Commissioners or of
visitors having jurisdiction in the place where the cause of
prosecution has arisen or the penalty been incurred, or with
the consent of her Majesty’s Attorney-General or Solicitor
General for England for the time being.
107. And be it enacted, That notwithstanding the repeal
of the several Acts hereinbefore repealed, every offence hereto-
fore committed against any of the provisions of any of the
same Acts may be prosecuted, and every penalty heretofore in-
curred by any person for any offence against the provisions of
any of the same Acts may be sued for and recovered, by the
Secretary of the Commissioners, in the same manner and with
all the same powers and rights as if such offence had been
committed, or such penalty incurred for an offence against the
provisions of this Act; and every penalty so recovered shall
LUNACY act, 1845: 8&9 vicr. c.100 347
be applied in the same manner as a penalty recovered for an
offence against the provisions of this Act.
108. And be it enacted, That when any person shall be
proceeded against, under the provisions of this Act, for omit-
ting to transmit or send any copy, list, notice, statement, or
other document hereinbefore required to be transmitted or sent
by such person, and such person shall prove by the testimony
of one witness upon oath that the copy, list, notice, statement,
or document in respect of which such proceeding is taken was
put into the post in due time, or (in case of documents required
to be transmitted or sent to the Commissioners or a Clerk of
the Peace) left at the office of the Commissioners or of the
Clerk of the Peace, and shall have been properly addressed,
such proof shall be a bar to all further proceeding in respect
of such omission. :
109. And be it enacted, That the costs, charges, and ex-
penses incurred by or under the authority or order of the
Commissioners in proceedings under this Act, shall be paid by
the Secretary of the Commissioners, and included by him in
the account of receipts and payments hereinbefore directed to
be kept by him; and that the costs, charges, and expenses in-
curred by or under the order of any visitors in proceedings
under this Act shall be paid by the Clerk of the Peace of their
county or borough, and included by him in the account of
receipts and payments hereinbefore directed to be kept by
him.
110, And be it enacted, That two or more of the Commis-
sioners, one at least of whom shall be a physician or surgeon,
and one at least a barrister, shall and may, once or oftener in
each year, on such day or days, and at such hours of the day,
and for such length of time as they shall think fit, visit every
asylum for lunatics, and every gaol* in which there shall be or
alleged to be any lunatic, and shall inquire whether the provi-
sions of the law have been carried out as to the construction of
each asylum visited, and as to its visitation and management,
and also as to the regularity of the admissions and discharges
of patients therein and therefrom; and whether divine service
is performed therein; and whether any system of coercion
is in practice therein, and the result thereof; and as to the
classification or non-classification of patients therein, and the
* Vide 25 & 26 Vict. c. 111, 8. 30.
No person
to be punish-
able for
omitting to
send any
copy, &c.,
if proved to
have been
put in the
post, or left
at the pre-
per office.
Costs in-
curred by
the Com-
missioners
to be paid
by their
Secretary,
and costs
incurred by
visitors by
the Clerk of
the Peace,
Commis-
sioners to
visit asylums
and gaols.
Provision
for the visi-
tation of
lunatics
under the
care of com-
mittees, and
also of State
and criminal
lunatics, and
other luna-
tics not com-
prised in the
preceding
provisions.
Power for
the Lord
Chancellor
and Secre-
tary of State
for the
Home De-
partment
to authorise
@ special
visitation of
any place
where a
lunatic is
represented
to be con-
fined,
348 MANUAL OF LUNACY
number of attendants on each class; and as to the occupations
and amusements of the patients, and the effects thereof ; and as
to the condition, as well mental as bodily, of the pauper patients
when first received ; and also as to the dietary of the pauper
patients; and shall also make such other inquiries as to every
or any such asylum, and all such inquiries as to the lunatics in
any gaol, as to such visiting Commissioners shall seem meet,
*112, And be it enacted, That it shall be lawful for the Lord
Chancellor, in the case of any lunatic under the care of a
committee appointed by the Lord Chancellor, and for the Lord
Chancellor, or her Majesty’s principal Secretary of State for
the Home Department, in the case of any lunatic under the
care of any pergon receiving or taking the charge of such one
lunatic only, and deriving no profit from the charge, and in
the case of any person confined .as a State lunatic, or as a
lunatic under the order of any criminal court of justice, and in
the case of every other person detained or taken charge of asa
lunatic, or represented to be a lunatic, or to be under any re-
straint as a lunatic, at any time, by an order in writing under
the hand of the Jaord Chancellor or the said Secretary of State,
as the case may be, directed to the Commissioners or any of
them, or to any other person, to require the persons or person
to whom such order shall be directed, or any of them, to
visit and examine such lunatic or supposed lunatic, and to
make a report to the Lord Chancellor, or to her Majesty's
principal Secretary of State for the Home Department, of such
matters as in such order shall be directed to be inquired into.t
118. And be it enacted, That it shall be lawful for the
Lord Chancellor or her Majesty’s principal Secretary of State
for the Home Department to employ any Commissioner ap-
pointed under this Act, or other person, to inspect or inquire
into the state of any asylum, hospital, gaol, house, or place
wherein any lunatic, or person represented to be lunatic, shall
be confined, or alleged to be confined, and to report to him the
result of such inspection and inquiry; }{ and every such person
so employed and not being a Commissioner, may be paid such
suni of money for his attendance and trouble as to the Lord
Chancellor or her Majesty’s principal Secretary of State for
* Sec, 111 is repealed by 16 & 17 Vict. c. oth s. 28,
t Vide 16 & 17 Vict. e. 96, ss. 38, 34,
} Vide 25 & 26 Vict. e. 111, s. 31.
Lunacy act, 1845: 8 & 9 vicr. c. 100 349
the Home Department shall seem reasonable ; and every such
person so employed, whether a Commissioner or not, shall be
allowed his reasonable travelling or other expenses while so
employed ; and such sum of money for attendance and trouble,
and such expenses, shall be charged on and shall be paid out
of the Contingency Fund of the Home Office.
114, And be it enacted, That in this Act and the schedules
thereto the words and expressions following shall have the
several meanings hereby assigned to them, unless there shall
be ‘something in the subject or context repugnant to such con-
struction, that is to say:
“Borough” shall mean every borough, town, and city
corporate having a separate quarter sessions, recorder,
and clerk of the peace. :
“County ” shall mean every county, riding, division of a
county, county of a city, county of a town, liberty, and
other place having a separate commission of the peace,
and not being a “ borough ” within the meaning afore-
said. :
The Lord Chancellor ” shall mean the Lord High Chan-
cellor, the Lord Keeper or Commissioners of the Great
Seal of Great Britain, and other the person or persons
for the time being entrusted, by virtue of the Queen’s
sign manual, with the care and commitment of the
custody of the persons and estates of persons found idiot,
lunatic, or of unsound mind.
“ Barrister” shall mean a barrister and a serjeant-at-law ;
and a serjeant-at-law who shall have been called to the
bar five years or more before his appointment to be a
Commissioner shall be considered as a barrister of five
. years’ standing.
“Lunatic” shall mean every insane person, and every
person being an idiot or lunatic or of unsound mind.
“ Payish ” shall mean any parish, township, hamlet, vill,
tithing, extra-parochial place, or place maintaining its
own poor.
“Officiating Clergyman of a [or the] Parish” shall mean
a clergyman regularly officiating and acting as the
Interpreta-
tion clause.
350 MANUAL OF LUNACY
minister or one of the ministers of a parish, chapelry, or
ecclesiastical district.*
“Borough Rate” shall mean a borough rate, and any funds
assessed upon or raised in or belonging to any borough
in the nature of @ borough rate, and applicable to the
purposes to which borough rates are applicable,
“County Rate” shall mean a county rate, and any funds
assessed upon or raised in or belonging to any county in
the nature of a county rate, and applicable to the pur-
poses to which county rates are applicable.
* Pauper ” shall mean every person maintained wholly or
in part at the expense of any parish, union, county, or
borough.
“ Patient ” shall mean every person received or detained as
a lunatic, or taken care or charge of as a lunatic.
“Private Patient” shall mean every patient who is not a
pauper.
“ Proprietor ” shall mean every person to whom any licence
has been granted under the provisions of any Act hereby
repealed, or shall be granted under the provisions of this
Act, and every person keeping, owning, having any
interest, or exercising any duties or powers of a proprie~
tor in any licensed house.
Clerk of the Peace” shall mean every clerk of the peace
and person acting as such, and every deputy duly ap-
pointed.
“ Medical Attendant” shall mean every physician, surgeon,
and apothecary t who shall keep any licensed house, or
shall in his medical capacity attend any licensed house,
or any asylum, hospital, or other place where any lunatic
shall be confined.
“Justice ” shall mean a justice of the peace.
“ Asylum” shall mean any lunatic asylum already erected
and established under an Act passed in the forty-eighth
year of the reign of his late Majesty King George the
48 G.3, 0. 96, Third, intituled “ An Act for the better Care and Main-
* Vide 16 & 17 Vict. c. 96, 8. 36.
tT Vide 25 & 26 Vict. c. 111, 8. 47,
LuNacy act, 1845: 8 & 9vicr. c.100 351
tenance of Lunatics, being Paupers or Criminals in
England,” or erected and established, or hereafter to be
erected and established, under or which have been made
subject or liable to any of the provisions of an Act passed.
in the ninth year of the reign of his late Majesty King
George the Fourth, intituled “An Act to amend the
Laws for the Erection and Regulation of County Lunatic
Asylums, and more effectually to provide for the Care
and Maintenance of Pauper and Criminal Lunatics in
England,” or hereafter to be erected and established under
the provisions of any Act for the erection or regulation
of county or borough lunatic asylums.
“Hospital” shall mean any hospital or part of an hospital
or other house or institution (not being an asylum)
wherein lunatics are received, and supported wholly or
partly by voluntary contributions, or by any charitable
bequest or gift, or by applying the excess of payments of
some patients for or towards the support, provision, or
benefit of other patients.
“ Licensed House ” shall mean a house licensed under the
provisions of this Act, or of some Act hereby repealed,
for the reception of lunatics.
“Oath” shall mean an oath, and every affirmation or other
declaration or solemnity lawfully substituted for an
“oath” in the case of Quakers or other persons exempted
by law from the necessity of taking an oath.
Words importing the singular number shall include the
plural number, and words importing the plural number
shall include the singular number, and words importing
the masculine gender shall include females,
115. And be it enacted, That for the purposes of this Act
every borough and county shall include every place situate
within the limits of such borough or county, and not having a
separate commission of the peace ; and for the purposes of this
Act every place situate within the limits of any borough or
county, and not having a separate commission of the peace,
shall be within the jurisdiction of the justices of such borough
or county ; and that the justices of every borough shall, for
the purposes of this Act, assemble in special sessions at such
times as the quarter sessions for such borough shall be holden ;
9G.4, c. 40,
Boroughs
and counties
to comprise
all places
therein not
‘having se-
parate Com-
Inission of
the Peace.
352 MANUAL OF LUNACY
and that all acts hereinbefore required to be done by the
justices of counties in general or quarter sessions assembled
may be done by the justices of boroughs at such special ses-
sions.
Act not to 116. And be it enacted, That nothing in this Act contained
extend to shall extend to the royal hospital of Bethlehem, or any build-
Hospital. ing adjacent thereto and used therewith: Provided always,
that it shall be lawful for any Commissioner or other person
whom the Lord Chancellor or any one of her Majesty’s princi-
pal Secretaries of State shall at any time, by an order in writ-
ing under the hand of the said Lord Chancellor or Secretary
of State, direct, to visit and examine the royal hospital of
Bethlehem, and every or any building adjacent thereto as
aforesaid, and every or any person confined therein.*
‘Kektetbe 117, And be it enacted, That this Act shall extend only to
ae England and Wales. ,
Wales, 118. And be it enacted, That this Act may be amended or
Alteration repealed by any Act to be passed in this present session of
of Act, .
Parliament.
* Repealed by 16 & 17 Vict. c. 96, 8, 25.
LUNACY acT, 1845: 8&9 vict.c.100 353
Schedules referred to by the foregoing Act.
SCHEDULE (A)* Section 80.t
Form of Licence.
Know all men, that we, the Commissioners in Lunacy [or we
the undersigned Justices of the Peace, acting in and for
in general [or quarter or special] sessions assembled],
do hereby certify, that 4.B. of in the parish of
in the county of hath delivered to us [or the Clerk of
the Peace] a plan and description of a house and premises pro-
posed to be licensed for the reception of lunatics, situate at
in the county of [or, im the case of a renewed licence,
hath delivered to us [or the Clerk of the Peace] a list of the number
of patients now detained in a house and premises licensed on the
day of last, for the reception of lunatics,
situate at in the county of ], and we, having
considered and approved the same, do hereby authorise and em-
power the said 4.B., (be intending [or not intending]
to reside therein) to use and employ the said house and premises
for the reception of “male [or female, or
male and female] lunatics, of whom not
more than shall ‘be -private patients, for the space of
calendar months from this date.
Sealed with our common seal [or given under our hands and
seals], this day of in the year of our Lord
18. ‘
Witness,
Y.Z., Secretary to the Commissioners of Lunacy,
[or Clerk of the Peace.]
* Vide Schedule (A) annexed to 25 & 26 Vict. c. 111
+ Schedules B, C, and D repealed by 16 & 17 Viet.c. 96,8. 3.
AA
354 MANUAL OF LUNACY
SCHEDULE (£)
REGISTRY OF
REGISTER OF
g 3/4
a ; Condition] gg | 3 de
Bl: Sex and Class as to 88 q Aa
eelB| s Marriage| 5 3 |] 8
83/4| & | Christian and ge |5)*
Bels| fi a3 |2| sa
c= e| 4 O .
ag 3 3 SuEnanie Private] Pauper ae = 4 = Ba
BBZI61 a at Length og 3 S58 a] eg |
gaia] ° Ze 3 3 6 | BE
25|3| 3 miv.Jucjr| |£//3| 22 | 8 | 8s
Ae! A S/Z/Fl 8 & 3
1846: ; ;
1 [Jan, 3/ William Johnson| - | - | 1 |-| 23 | - | 1 | - | Carpenter --
2
3 |
1848 : il ‘H
4 |June 9/ William Johnson| - | -|1|-| 25/-|1]/-] - -|J--
5
6
1852:
7 |May 6/William Johnson] - | -|1/-|] 29/1)}-]|- = |S eS
8
355
: 8&9 vict. c. 100
LUNACY act, 1845
Sxction 50.
ADMISSIONS.
PatIENTs.
SULOTBAIOSO)
ped
[posordwmy JON
peaslyey
Dis-
charged
peraaccey
qo
10 odreyosiq jo aed
1848 :
Dec. 2 | 1
1853 :
June 8
3OBIVV SIT UO ey
sy004
-y¥ snotacid jo tequim yy
1846 :
2)17| Sept.1] 1
3
4
sya
su}UOW
s1voz
Duration
lof existing|
Attacks
SqOIPT TeHUEBUOD
sondondy
Aguaes
-ul jo esneg pesoddng
Form of
Mental
Disorder
(Aue Jl) Jop1osiql Jo ewMBN
uonrpuog ATrpod
jr |= Melancholia
peusis
moya fq pus ‘seqwo
-GIgt0H TeoTpenl JO sezeC.
quas Aqioqyny esoqas Agr
AA
356 MANUAL OF LUNACY
SCHEDULE (F) Sscrion 52.
Notice of Admission.
I werepy give you notice, that A.B. was received -into this
house [or hospital] as a private [ar pauper] patient on the
day of — and I hereby transmit a copy of the Order and
Medical Certificates [or Certificate] on which ho was received.
Subjoined is a statement with respect to the mental and bodily
condition of the above-named patient.
(Signed)
Superintendent [or Proprietor] of
Dated this day of One thousand
eight hundred and .
STATEMENT,
I wave this day seen and personally examined
the patient named in the above Notice, and hereby certify that with
respect to mental state he [or she] _ ; and that with
respect to bodily health and condition he [or she]
(Signed)
Medical Proprietor [or Superintendent,
or Attendant].
Dated this day of One thousand .
eight hundred and :
357
: 8&9 vicr. c. 100
LuNacy act, 1845
uw
‘a|w
g
8
4 | weed
2.
3 qe ony
a
sma }- }t}- )- |- |- |- |- |- |r ]- | - | sosugoe emma | oie | eeune
*S98T = 6S8L
L}- | |- | - | vosaqor wenn r 6oune % ‘0a,
> SP8T + 8¥8T
T |- | [> fo | wosaor wena I § ‘uee T‘adeg
: OF8T : OF8T
“EW a a | a Oa oe | a | OW
“qWy89q 3 yysuery syuoryed woTssTupY Gyo,
Aorduay| aTOA
yo osneo Peon [Pose vcooy | awed | FAH | ge oueumg pue yo qe | eee
para Se BU | yo ou | PSHEUOSTA
pousissy ON Jo age
pesreyqosiq. SSBID pus xeg
‘SHLVEGQ: GNV SWOUVAOSIGG AO AMLSIOAY
‘yg Noloag (1 9) AIOGHHOS
358 MANUAL OF LUNACY
SCHEDULE (G 2) Szcrton 54.
Form of Notice of Discharge or Death.*
I HEREBY give you notice, that a private [or
pauper] patient, received into this house [or hospital] on the
day of was discharged therefrom recovered
[or relieved, or not improved,] by the authority of [or
died therein], on the day of -
(Signed)
Superintendent [or Proprietor] of
house [or hospital] at
Dated this day of One thousand eight
hundred and ’ +
In case of death, add ‘and I further certify, that A.B. was present
at the death of the said ; and that the apparent
cause of death of the said [ascertained by post-
mortem examination (if so) ] was 2
* This must be sent to Commissioners within two clear days from
time of discharge.
LUNACY act, 1845: 8&9 vicr. c. 100 359
squared
0} S8OTO[OLA,
pue
‘sopmmfar
‘sqyeo,
yevidsoH 10 esnoy jo
WOTyTPUOD,
pu sjuereg jo ~
UyTeeH 30 07899
uo ylodey
soyeutagy Solel
sopeueT soreyL
“2 | °M) “|W
quoury vole
yeorpan topun
squorted JO Soume yy
WOISNTIIg UT 10
(suveyy yey Aq pus)
qurexysey tapun
squared “JO soueyT
s
qodnog { OYtAlg
squeyeg Jo 1equinyy
eyed,
‘IMOdTY AINTTAA GNV TVNEQOP TVOIaayY JO WAOT
‘pg Nollosg (H) AINGHHOS
360 MANUAL OF LUNACY
SCHEDULE (I) Secrion 100.
Form of Summons,
We, the Commissioners in Lunacy [or we whose names are
hereunto set and seals affixed, being Two of the Commissioners in
Lunacy, or Visitors] appointed under or by virtue of an Act passed
in the year of the reign of her present Majesty,
intituled [here insert the Title of the Act], do hereby summon and
require you personally to appear before us at in the -
parish of in the county of on
next the day of at the hour of
in the noon of the same day, and then and there to be
examined, and to testify the truth touching certain matters relating -
to the execution of the said Act.
Sealed with the Common Seal of “ The Commissioners in Lunacy”
[or given under our hands and seals], this = day of
in the year of our Lord One thousand eight handred and ‘
f
LUNACY act; 1853: 16 &17 vict. c. 96 361
II.
ANNO DECIMO SEXTO & DECIMO SEPTIMO VIC-
TORIA REGINA,
CAP. XCVI.
An Act to amend an Act passed in the ninth Year of her Majesty,
for the Regulation of the Care and Treatment of Lunatics.
August 20th, 1853,
WHEREAS an Act was passed in the ninth year of her Majesty,
“for the Regulation of the Care and Treatment of Lunatics: ”
and whereas it isexpedient to amend the said Actas hereinafter
mentioned: Be it therefore enacted by the Queen’s most excel-
lent Majesty, by and with the advice and consent of the Lords
Spiritual and Temporal, and Commons, in this present Parliament
assembled, and by the authority of the same, as follows :—
1. Section twenty-five of the said recited Act shall be re-
pealed, and any one licence to be granted for the reception of
lunatics may, in the discretion of the Commissioners or justices
granting such licence, include two or more houses belonging to
one proprietor or to two or more joint proprietors, provided
that no one of such houses be separated from the other or
others of them otherwise than by land in the same occupation,
and by a road, or by either of such modes; and all houses,
buildings, and lands intended to be included in any licence
shall be specified, delineated, and described in the plan required
by section twenty-four of the said recited Act.”
2. No person having, after the passing of the said recited
Act, received for the first time a licence for the reception of
lunatics, or hereafter receiving for the first time such licence,
shall receive a licence unless he shall reside on the premises
licensed ; and no two or more persons having, after the passing
of the said recited Act, received for the first time a joint licence
* Vide 8 & 9 Vict. ¢. 100, 8. 24; 25 & 26 Vict. c, 111, 3, 14.
8 & 9 Vict.
ec. 100,
Section 25 of
recited Act
repealed,
and provi-
sion as to
what may
be included
in one ~
licence.
The person
or one of the
persons re-
ceiving a
licence to
reside on the
premises,
Sections 45,
46, 47, 48
and 49 of
8 & 9 Vict.
c. 100, re-
pealed,
No person
not a pauper
to be re-
ceived into
a hospital
or licensed
house with-
out acertain
order and
certificates,
Proviso
that in cer-
tain cases
any person
may be re-
ceived on a
certificate
signed by
one medical
practitioner
only.
362 MANUAL OF LUNACY
for the reception of lunatics, or hereafter receiving for the first
time such licence, shall receive such licence unless they or one
of them shall reside on the premises licensed.*
8. Sections forty-five, forty-six, forty-seven, forty-eight, and
forty-nine of the said recited Act shall be repealed ; but such
repeal shall not prevent or defeat any prosecution for any of-
fence committed before the commencement of this Act, and
every such offence shall and may be prosecuted, and every .
pending prosecution continued, as if this Act had not been
passed.
4, Save as hereinafter otherwise provided,+ no person (not
being a lunatic), for or in respect of whom any money shall
be paid or agreed to be paid, shall be boarded or lodged in any
licensed house; and, save where otherwise provided or autho-
rised under this or any other Act, no person (not being a pau-
per) shall be received as a lunatic into any licensed house or
hospital without an order under the hand of some person
according to the form in Schedule (A) No. 1 annexed to this
Act, together with such statement of particulars as is con-
tained in the same schedule, nor without the medical certifi-
cates, according-to the form in Schedule (A) No, 2 annexed to
this Act, of two persons, each of whom shall be a physician,
surgeon, or apothecary, and shall not be in partnership with or
an assistant to the other,} and each of whom shall separately
from the other have personally examined the person to whom
the certificate signed by him relates not more than seven clear
days previously to the reception of such person into such house
or hospital; and such order as aforesaid may be signed before
or after the medical certificates or either of them; and every
person who shall receive any such person as aforesaid into any
such house or hospital as aforesaid (save where otherwise pro-
vided or authorised under this or any other Act) without such
order and medical certificates as aforesaid, shall be guilty of a
misdemeanour.§ :
5, Provided always, That any person (not a pauper) may,
under special circumstances preventing the examination of such
person by two medical practitioners as aforesaid, be received as
* Vide 25 & 26 Vict. c. 111, 8. 16.
t+ Vide 25 & 26 Vict. c. 111, s. 18.
} Vide 25 & 26 Vict. c. 111, 8. 24.
§ Vide 8 & 9 Vict. c. 100, s. 106.
LUNACY act, 1853: 16&17 vier. c. 96 363
a lunatic into any licensed house or any hospital upon such
order as aforesaid, and with the certificate of one physician,
surgeon, or apothecary alone, provided that the statement
accompanying such order set forth the special circumstances
which prevent the examination of such person by two medical
practitioners; but in every such case two other such certificates
shall, within three clear days after his reception into such
house or hospital, be signed by two other persons, each of
whom shall be a physician, surgeon, or apothecary, not in
partnership with or an assistant to the other, or the physician,
surgeon, or apothecary who signed the certificate on which the
patient was received, and not connected with such house or
hospital, and shall within such time and separately from the
other of them have personally examined the person so received
as a lunatic; and every person who, having received any person
as a lunatic into any house or hospital as aforesaid, upon the
certificate of one medical practitioner alone as aforesaid, shall
keep or permit stich person to remain in such house or hos-
pital beyond the said period of three clear days without such
further certificates as aforesaid, shall be guilty of a misde-
meanour, *
6. Provided also, That it shall be lawful for the proprietor
or superintendent of any licensed house,* with the previous
Sssent in writing of two of the Commissioners, such assent not
to be given until after such Commissioners have, by personal
examination of the patient, satisfied themselves of his desire
to remain, to entertain and keep in such house as a boarder any
person who may have been discharged as a patient from such
house for such time after such discharge as he may desire to
femain, not exceeding the time specified in such assent, and
‘Iso, for the benefit of any patient in such house, and with the
frevious assent in writing of two of the Commissioners, to re-
peive and accommodate as a boarder therein, for a time to be
ipecified in the assent, any relative or friend of such patient,
ind any two of the Commissioners may from time to time, by
my writing under their hands, extend or revoke any such
wsent as aforesaid; and every such patient so retained after
\scharge, and every such relative or friend so accommodated,
hall, if required, be produced to the Commissioners and
isitors respectively at their respective visits.
* Vide 25 & 26 Vict. c.111, 8. 18.
Any person
discharged
may, with
assent of
visitors or
Commis-
sioners, be
retained in
licensed
house, and a
relative or
friend may,
with like
assent, be
received
therein,
Panpers not
to be re-
ceived with-
out a certain
order and
certificate.
The like
order and
certificates
for recep~
tion of a
single pa-
tient as for
reception of
a private
patient into
a licensed
house.
Penalty on
officers, &c.,
illtreating
Innatics,
364 MANUAL OF LUNACY
7. Save where otherwise provided or authorised under any:
Act, no pauper shall be received into any licensed house or any
hospital without an order according to the form in Schedule (B)
No. 1, annexed to this Act,* under the hand of one justice, or
under the hands of an officiating clergyman, and the relieving
officer or one of the overseers of the union or parish from
which such pauper shall be sent, together with such statement
of particulars as is contained in the same schedule, nor with-
out the medical certificate, according to the form in Schedule,
(B) No. 2, annexed to this Act, of a physician, surgeon, ot!
apothecary, who shall have personally examined the pauper to
whom it relates not more than seven clear days previously to
his reception ; and every person who shall receive any pauper
into any such house or hospital as aforesaid (save where other-
wise provided or authorised under any Act) without such ordey
and medical certificate as last aforesaid, shall be guilty of a
misdemeanour: Provided always, that this enactment shall not’
by implication or otherwise give any power or authority to
make such order, or extend, alter, or affect any power or
authority expressly given by any Act to any justice, officiating |
clergyman, relieving. officer, or overseer to make or join in’
making any such order, or any provisions giving or relating to
such power or authority. ;
8. Where, under section ninety of the said recited Act, t
the like order and medical certificates are required on the re-
ception or taking the charge or care of any one person as a luna
tic or alleged lunatic as are thereinbefore required on the Te
ception of a patient (not being a pauper) into a licensed house,’
the like order and medical certificates (in lieu of those required
as first aforesaid) shall hereafter be required on the recepticl
or taking the charge or care of any such person as are by thit
Act required on the reception of a patient (not being a pauper}
into a licensed house. ;
9. If any superintendent, officer, nurse, attendant, servant,
or other person employed in any registered hospital or licensad,
house, or any person having the care or charge of any single!
patient, or any attendant of any single patient, in any way’
abuse, or ill-treat, or wilfully neglect any patient in such ho:
pital or house, or such single patient, or if any person detaining;
* Vide 25 & 26 Vict. c. 111, ss. 25, 26, 31, 32, 33,
t+ Vide 8 & 9 Vict. c, 100, s. 90.
I
LUNACY act, 1853: 16 & 17 vict. 6. 96 365
or taking or having the care or charge, or concerned or ‘taking
part in the custody, care, or treatment, of any lunatic or per-
son alleged to be a lunatic, in any way abuse, ill-treat, or wil-
fully neglect such lunatic or alleged lunatic, he shall be guilty
of a misdemeanour, and shall be subject to indictment for
every such offence, or to forfeit for every such offence, on a
summary conviction thereof before two justices, any sum not
exceeding twenty pounds.
_ 10. Every physician, surgeon, and apothecary signing any
certificate under or for the purposes of this Act shall specify
therein the facts upon which he has formed his opinion that the
person towhom such certificate relates is a lunatic, an idiot, or a
person of unsound mind, and distinguish in such certificate facts
observed by himself from facts communicated to him by others;
and no person shall be received into any registered hospital or
‘licensed house, or as a single patient, under any certificate
which purports to be founded only upon facts communicated
by others.
' 11. If after the reception of any lunatic it appear that the
order or the medical certificate, or (if more than one) both or
either of the medical certificates, upon which he was received,
is or are in any respect incorrect or defective, such order and
medical certificate or certificates may be amended by the per-
son signing the same at any time within fourteen days next
after the reception of such lunatic ; Provided nevertheless, that
no such amendment shall have any force or effect unless the
same shall receive the sanction of one or more of the Com-
missioners.” :
_ 12. No physician, surgeon, or apothecary who, or whose
Father, brother, son, partner, or assistant, is wholly or partly
he: proprietor of, or a regular professional attendant in, a
licensed house or a hospital, shall sign any certificate for the
reception of a patient into such house or hospital; and no
physician, surgeon, or apothecary shall himself, or by his ser-
wants or agents, receive to board or lodge in any unlicensed
house, or take the charge or care of any person upon or under
any medical certificate signed by himself or his father, brother,
kon, partner, or assistant ; and no physician, surgeon, or apothe-
ary having (either before or after the passing of this Act) signed
any certificate for the reception of any person shall be the regu-
* Vide 25 & 26 Vict. c. 111, s. 27.
Medical cer-
tificate to
specify facts
upon which
opinion of
insanity has
been formed.
Orders and
medical cer-
tificates may
be amended.
Who not to
sign certifi-
cates, &c.
A medical
man giving
false certifi-
entes, &c.,
and a person
not being a
medical man
giving certi-
ficates as
such, guilty
of a misde-
meanour.
Commis-
sioners may
permit medi-
cal visitation
of any single
patient leas
frequently
than once a
_fortnight,
but if pa-
tient be in
the care of a
medical man
he is tomake
an entry
once a fort-
night as to
patient’s
health.
Visitors of
licensed
houses may
visit single
patients on
request of
Commis-
-sioners.
366 MANUAL OF LUNACY
lar professional attendant of such person while under care or
charge under such certificate; and no’ physician, surgeon, or
apothecary who, or whose father, brother, son, partner, or
assistant shall sign the order hereinbefore required for the re.
ception of a patient, shall sign any certificate for the reception :
of the same patient.
18. Any physician, surgeon, or apothecary who shall sign
any certificate, or do any other act (not declared to be a mis
demeanour) contrary to any of the provisions herein con-
tained, shall for every such offence forfeit any sum not ex-
ceeding twenty pounds; and any physician, surgeon, or
apothecary who shall falsely state or certify anything i in any
certificate under this Act, and any person who shall sign any
certificate under this Act i in which he shall be described as a
physician, surgeon, or apothecary, not being a physician, sur-
geon, or apothecary respectively within the meaning of this
Act, shall be guilty of a misdemeanour.
14, It shall be lawful for the Commissioners, by an order
under their common seal, where they see fit so to do, to permit
the visitation of any single patient by a physician, surgeon, or
apothecary less frequently than once in every two weeks, as
required by section ninety of the said recited Act, and to
“prescribe from time to time how often any single patient shall
be visited by such a physician, surgeon, or apothecary as
therein mentioned ; but where such visitation of any single’
patient so often as once in every two weeks is so dispensed
with, and such patient is in the care or charge of a physician,
surgeon, or apothecary, such physician, surgeon, or apothecary
shall once at the least in every two weeks make an entry in a
‘book to be kept for that purpose, to be called “The Medical
Journal,” of the condition of the patient’s health, both mental
and bodily, together with the date of such entry, and such
book shall be produced to the visiting Commissioner on every
visit, and shall be signed by him as having been so produced;
and every such physician, surgeon, or apothecary who shall
make an untrue entry in the said book shall be guilty of a
misdemeanour.
15. It shall be lawful for one or more of the visitors ap-
pointed in or for any county or borough under the said recited
Act, upon the request in writing of the Commissioners, or any
two of them, under their hands, so to do, to visit any person
detained in any unlicensed house in such county or borough as
LUNACY act, 1853: 16 & 17 vict. c. 96 367
a single patient, and to inquire into and report to the Commis-
sioners on the treatment and state of health, bodily and mental,
of such patient, and to inspect the order and certificates on
which such person was received; and the provisions of the said
recited Act for and concerning the remuneration or payment of
any such visitor, being a physician, surgeon, or apothecary, in
respect of the execution of the duties of that Act, and for the
payment of the costs, charges, and expenses incurred by any
visitor in proceedings under that Act, shall extend and be
applicable to and for the remuneration or payment of any
visitor, being a physician, surgeon, or apothecary, visiting as
aforesaid any single patient, and to and for the payment of the
costs, charges, and expenses incurred by any visitor in or about
such visit as aforesaid.
16. Every physician, surgeon, and apothecary who visits
any single patient, or under whose care or charge any single pa-
tient shall be, shall on the tenth day of January, or within seven
days from that time, in every year report in writing to the Com-
missioners the state of health, bodily and mental, of such patient,
with such other circumstances as he may deem necessary to be
communicated to the Commissioners; and it shall be lawful for
the Commissioners, at any other time and from time to time as
they see occasion, to call for and require from any such physician,
surgeon, or apothecary a report in writing relative to any single
patient visited by him or under his care or charge in such form
and specifying such particulars as the Commissioners may direct.
17. The provisions contained in sections seventy-two and
seventy-three of the said recited Act for the discharge of pa-
tients (not being paupers) from licensed houses shall extend
and be applicable to and for the discharge of any single patient :
Provided always, that this enactment shall not extend to au-
thorise the discharge of any single patient, if the physician,
surgeon, or apothecary who has the care or charge of, or visits
such patient, certify in writing under his hand that in his
opinion such patient. is dangerous and unfit to be at large,
together with the grounds on which such opinion is founded,
unless one of the Commissioners shall consent in writing to
the discharge of such patient.
18. It shall be lawful for the Lord Chancellor, upon the
report of the Commissioners in Lunacy, to order the discharge
of any person received or detained as a single patient, or to
give such orders and directions in reference to such patient as
Annual re-
port to be
made to the
Commis-
sioners by
every medi-
cal man
visiting or
having
charge of a
single
patient.
Provisions
concerning
discharge of
patients
from licen-
sed houses
by relatives
extended to
single pa-
tients.
Lord Chan-
cellor, upon
Report of
Commis-
sioners, may
order dis-
charge, &c.,
of any single
patient.
On recovery
of a patient
notice to be
given to
friends, and
in the case
of a pauper
toguardians,
&c., and in
default of
discharge or
removal to
Commis-
sioners and
visitors.
Provision in
case of death
of patient in
any hospital
or licensed
house.
Provision
authorising
transfer of
368 MANUAL OF LUNACY
the Lord Chancellor shall think fit; and any person detaining
any such patient for the space of three days after a copy of
such order for his discharge shall have been served on him, or
left at the house in which such person so ordered to be dis-
charged is detained, shall be guilty of a misdemeanour.
19. The euperintendent or proprietor of every registered
hospital and licensed house, and every person having the care
or charge of any single patient, shall forthwith, upon the re-
covery of any patient in such hospital or house, or of such
single patient, transmit notice of such recovery in the case of a
patient not a pauper to the person who signed the order for
his reception, or by whom the last payment on account of such
patient was made, and in the case of a pauper to the guardians
of his union or parish, or if there be no such guardians to one
of the overseers of the poor of his parish, or if such pauper be
chargeable to any county, to the Clerk of the Peace thereof,
and in case such patient be not discharged or removed within
fourteen days from the giving of such notice, such superin-
tendent, proprietor, or person as aforesaid shall immediately
after the expiration of such period transmit notice of the re-
covery of such patient to the Commissioners, and also, in the
case of a licensed house within the jurisdiction of any visitors,
to the clerk of such visitors, with the date of the notice firstly
in this enactment mentioned, and where notice is so given to
the clerk of any visitors, he shall forthwith communicate
the same to the visitors, or two of them, one of whom shall
be a physician, surgeon, or apothecary; and in case of the
death of any patient in any hospital or licensed house, a state-
ment setting forth the time and cause of the death, and the
duration of the disease of which such patient died, shall be
prepared and signed by the medical person or persons who
attended the patient during the illness which terminated in
death, and such statement shall be entered in the “Case Book,”
and a copy of such statement, certified by the superintendent
or proprietor, shall within two days of the date of the death
be transmitted to the coroner for the county or borough, and
in case such coroner, after receiving such statement, shall
think that any reasonable suspicion attends the cause and
circumstances of the death of such patient, he shall summon a
jury to inquire into the cause of such death.
20. Any person, having authority to order the discharge of
any patient (not being a pauper) from-any asylum, registered
LUNACY act, 1853: 16 & 17 vict. c.96 369
hospital, or licensed house, or of any single patient, may, with
the previous consent in writing of two of the Commissioners,
direct by an arder in writing under his hand the removal cf
such patient to any asylum, registered hospital, or licensed:
house, or to’ the care or charge of any person mentioned or
named in such order; and every such order and consent shall
be made and given respectively in duplicate, and one of the
duplicates shall be delivered to and left with the superintendent
or proprietor of the asylum, hospital, or house, from which or
the person from whose care or charge the patient is ordered to
be removed, and the other duplicate shall be delivered to and
left with the superintendent or proprietor of the asylum, hos-
pital, or house into which, or the person into whose care or
charge the patient is ordered to be removed; and such order
for removal, together with such consent in writing, shall be a
‘sufficient authority for the removal of such patient, and also
for his reception into the asylum, registered hospital, or li-
censed house into which or by the person into whose care or
charge he is ordered to be removed: Provided always, that a
copy of the order and certificates upon which such patient was
received into the asylum, hospital, or house from which he is
removed, or as a single patient, by the person from whose care
he is removed, certified under the hand of the superintendent
or proprietor of such asylum, hospital, or house, or of such
person as last aforesaid, to'be a true copy, shall be furnished
by him free of expense, and shall be delivered, with one dupli-
cate of the said order of removal and consent, to the superin-
tendent or proprietor of the asylum, hospital, or house to
which or to the person to whose care or charge such patient is
removed.
21, Every person from whose care or charge any single pa-
tient shall be discharged. shall transmit to the Commissioners
a written notice of such discharge within the like period, and
under the like penalty for default, as by the said recited Act is
required and provided in the case of the discharge of a patient
from a licensed house.
92, It shall be lawful for any person having the care or
charge of a single patient to change his residence, and remove
such patient to any new residence of such person, in England,
‘ provided that seven clear days before such change of residence
he give notice in writing thereof, and of the place of such new
residence, to the Commissioners and to the person who signed
BB
private and
single
patients.
Notice of
discharge
of single
patients to
be sent to
the Commis-
sioners.
Provisions
as to change
of residence
of persons,
vine
charge of
single pa-
tients, and
temporary
removal of
such pa-
tients for
benefit of
health.
On represen-
tation of
Commis-
sioners Lord
Chancellor
may require
statement of
property of
lunatic.
Form of
notice of
admission.
Form of
Medical
Visitation
Book,
370 MANUAL OF LUNACY
the order for the reception of such patient, or by whom the
last payment on account of such patient was made; and it
shall be lawful for any person having the care or charge of any
single patient, having first obtained the consent of two of the
Commissioners, to take or send such patient under proper con-
trol, to any specified place or places, for any definite time, for
the benefit of his health: Provided always, that before any
such consent shall be given, the approval in writing of the per-
son who signed the order for the reception of such patient, or
by whom the last payment on account of such patient was
made, shall be produced to such Commissioners, unless they
shall, on cause being shown, dispense with the same.
23, Where any person has already been received as a lunatic
under order and certificates, and shall be detained thereunder,
and where any person shall hereafter be in like manner received
and detained, and the Commissioners represent to the Lord
Chancellor that it is desirable that the extent and nature of his
income should be ascertained, and the application thereof, the
Lord Chancellor may, if he think fit, through the Registrar in
Lunacy, require that the person signing the order, or other the
person paying for the care and maintenance of the lunatic or
having the management of the property, shall transmit to the
Lord Chancellor a statement in writing, to the best of his
knowledge, of the particulars of the property and income of
the lunatic and of the application of the income.
24. The notice of admission and statement mentioned or
referred to in section fifty-two of the said recited Act shall
hereafter be according to the' form mentioned in Schedule (C)
annexed to this Act, in lieu of the form set forth in Schedule
(F) to the said recited Act; and such statement shall be signed
by the medical superintendent, proprietor, or attendant of the
hospital or licensed house from which the same is sent, and the
said notice and statement shall be accompanied by a copy of
the several documents mentioned in the said notice.*
25. The Medical Visitation Book mentioned in section fifty-
nine of the said recited Act, shall henceforth be kept in the
form set forth in Schedule (D) annexed to this Act, in lieu
of the form set forth in Schedule (H) to the said recited Act;
and the said section shall be construed as if the particulars ©
mentioned in the several heads of the said form in the said
* Vide 25 & 26 Vict. c. 111, s. 28,
.
LUNACY act, 1858: 16 & 17 viet. c. 96 371
Schedule (D) had by the said section been required to be
entered in the said book in lieu of the particulars mentioned in
the said section.
26, The superintendent or proprietor of every registered
hospital or licensed house shall, within one week after the dis-
missal for misconduct of any nurse or attendant employed in
such hospital or house, transmit to the Commissioners, by the
post, information in writing under his hand of such dismissal,
and of the cause thereof; and every superintendent or proprietor
neglecting to transmit such information to the Commissioners
within the period aforesaid, shall, for every such offence, forfeit
any sum not exceeding ten pounds.
27. Section eighty-nine of the said recited Act, constituting
from among the Commissioners a private committee for the
purposes in the said Act mentioned, shall be repealed, and all
the powers vested in, and all the provisions of the said Act
applicable to the said private committee, or one or two members
thereof, shall be vested in and be applicable to the Commis-
sioners, or one Commissioner, or two Commissioners (as the
case may require), as if, where in the said Act the said private
committee, or one member or two members thereof (as the
case may be), is or are mentioned, or referred to, the Commis-
sioners, or one Commissioner, or two Commissioners (as the
case may require), has been mentioned or referred to, instead
thereof.
28. Section one hundred and eleven of the said recited Act
shall be repealed, and any one or more of the Commissioners
shall and may on such day or days, and at such hours in the
day, and for such length of time as he or they shall think fit,
visit all such parish and union workhouses in which there shall
be or be alleged to be any lunatic, as the Commissioners shall
by any resolution or resolutions of the board direct, and shall
inquire whether the provisions of the law as to lunatics in such
parish or union have been carried out, and also as to the dietary,
accommodation, and treatment of the lunatics in such work-
houses, and shall report in writing thereon to the Poor Law
Board. 7
29. It shall be lawful for the Commissioners, where, for
any reasons to be entered upon the minutes of the board, any
case appears to them specially to call for immediate investiga-
tion, to authorise and direct, by an order under their common
seal, any competent person or a to visit and examine and
BB
Notice of
dismissal for
misconduct
of attend-
ants to be
sent to Com-
missioners.
Powers
vested in
Private
Committee
to be vested
in the Com-
missioners.
Repeal of
Section 111
of recited
Act, and
provision as
to visitation
of work-
houses.
Commission-,
ers may in
any special
case employ
persons to
make the
necessary
inquiries,
and to re-
port to them
thereon.
Regulations
for hospitals
to be sub-
mitted to
Secretary of
State.
Commis-
sioners may
make regu-
lations for
the govern-
ment of
licensed
houses,
Time at
372 MANUAL OF LUNACY
report to them upon the mental and bodily state and condition
of any lunatic or alleged lunatic in any asylum, hospital, or
licensed house, or of any pauper lunatic in a workhouse or
elsewhere, or of any lunatic or alleged lunatie under the’ care
or charge of any person as a single patient, and to inquire into
and report upon any matters into which the Commissioners are
authorised to inquire; and every such person shall, for the
special purposes mentioned in such order, have all the powers
of a Commissioner; and the Commissioners may allow to
every such person a reasonable sum for his services and
expenses, such sum to be paid in manner provided by the
said recited Act with regard to expenses incurred by or under
the authority of the Commissioners in proceedings thereunder ;*
but this enactment shall not be taken to exonerate the Com-
missioners from the performance of any duty by law imposed
on them,
30. The committee having the management or government:
of every registered hospital shall, within three months after
the passing of this Act in the case of every hospital now regis-
tered, and within three months after the registration of every
hospital hereafter to be registered under the said recited Act,
submit the existing regulations, or regulations to be framed by
such committee, to one of her Majesty’s principal Secretaries
of State, for his approval; and any such committee may, with
the like approbation, alter and vary such regulations as they
think necessary ; and all such regulations so approved shall be
printed, abided by, and observed, and a copy thereof shall be
sent to the Commissioners, and another copy thereof kept
hung up in the visitors’ room of the hospital.t
31. It shall be lawful for the Commissioners, with the
sanction and approbation of one of her Majesty’s principal
Secretaries of State, from time to time to make regulations for
the government of any house licensed for the reception of luna-
tics; and such regulations of the Commissioners, or a copy
thereof, shall be transmitted by their secretary to the proprietor
or resident superintendent of every licensed house to which the * °
same relate, and shall be abided by and observed therein.
82. The report required by section 88 of the said
* Vide 8 & 9 Vict. c. 100, ss. 38-35.
tT Vide 8 & 9 Vict. c. 100, s. 48.
LUNACY act, 1853: 16 & 17 vict. o. 96 373
. recited Act to be made by the Commissioners to the Lord
Chancellor in the month of June in every year of the state
and condition of the several houses, . hospitals, asylums, and
other places visited by them under that Act, and of the care
of the patients therein,and of such other particulars as they
think deserving of notice, shall be made in or before the month
of March in every year, and shall be made up to the end of
the preceding year.
33. The provision in section 118 of the said recited Act, for
and concerning the payment for attendance and trouble of any
person (not being a Commissioner) employed under that enact-
ment, and of the travelling or other expenses of any person so
employed, and as to the fund out of which such payment is to be
' made, shall extend and be applicable to and in the case of any
person (not being a Commissioner) required to visit and examine
any lunatic or supposed lunatic under section 112 of the said
recited Act.
34, Any person who wilfully obstructs the Commissioners
or any of them, or any other person authorised by an order in
writing under the hand of the Lord Chancellor or her Ma-
jesty’s principal Secretary of State for the Home Department,
pursuant to the provisions of section 112 or 113 of the said
recited Act, to visit and examine any lunatic or supposed
lunatic, or to inspect or inquire into the state of any asylum,
hospital, gaol, house, or place wherein any lunatic or person
represented to be lunatic is confined or alleged to be confined,
in the execution of such order; and any person who wilfully
obstructs any person authorised under this Act by any order of
the Commissioners to make any visit and examination or in-
quiry in the execution of such order shall (without prejudice
to any proceedings, and in addition to any punishment to
which such person obstructing the execution of such order
would otherwise be liable) forfeit for every such offence any
sum not exceeding twenty pounds, :
85. Section 116 of the said recited Act shall be repealed,
and the Royal Hospital of Bethlehem shall henceforth be
subject to the provisions of the said recited Act and of this
Act, in the same manner as if the same had not been exempted
from the said recited Act, and shall be forthwith registered as
an hospital accordingly, in pursuance of section 43 of the said
recited Act.
which re-
ports of |
Commis-
sioners to
the Lord
Chancellor
as to state of
asylums, wc.,
are to be
made,
Provision for
payment of
persons em-
ployed to
inspect
places where
lunatics are
confined ex-
tended to
persons
visiting
under s. 112
of 8 & 9 Vict.
ce. 100.
Penalty on
persons
obstructing
execution of
orders of
Lord Chan-
celloror ‘
Secretary of
State, made
under ss, 112
or 113 of
recited Act,
or of Com-
missioners
made under
this Act.
Section 116
of recited
Actrepealed,
and Bethle-
hem Hospital
to be subject
to this Act.
Tuterpreta-
tion of
terms,
Recited Act
and this Act
to be con-
strued as one
Act, &c,
Act not to
affect provi-
sions relat-
-ng:to crimi-
nal lunatics,
39 & 40 G.3,
0. 94; 1&2
Vict. c. 14,
and 3 & 4
Vict. c. 54,
save as here-
in provided.
374 7 MANUAL OF LUNACY
36. In the construction of the said recited Act and of this
Act the words “ physician,’ “surgeon,” and “ apothecary”
shall respectively mean * a physician, surgeon, and apothecary
duly authorised or licensed to practise as such by or as a mem-
ber of some college, university, company, or institution legally
constituted, and qualified to grant such authority or licence in
some part of the United Kingdom, or having been in practice
as an apothecary in England or Wales on or before the first
day of August, 1815, and being in actual practice as such
physician, surgeon, or apothecary. The expression “officiating
clergyman of the parish” shall include the chaplain of the
workhouse of the same parish, or of the workhouse of the
union to which such parish belongs. The expression “ single
patient” shall mean any person received or taken charge of as
a lunatic under section 90 of the said recited Act, or under
such section as amended by this Act; and the expression
“attendant” shall mean any person, whether male or female,
who shall be employed either wholly or partially in the per-
sonal care, control, or management of any lunatic in any regis-
tered hospital or licensed house, or of any single patient; and
in the construction of this Act the word “ Board,” as used in
relation to the Commissioners in Lunacy, shall mean any three
or more of the Commissioners assembled at a meeting convened
in pursuance of section 16 of the said recited Act, or holden
under any order or rule for the time being in force made under
section 70 of the said recited Act for Toqulting the duties of
the Commissioners.
37. The said recited Act and this Act shall be construed
together as one Act, and a Queen’s Printer’s copy of this Act
shall be bound up in the “ Visitors’ Book” of every hospital
and licensed house together with the said recited Act.
38. Nothing in this Act shall affect the provisions of any
of the following Acts (that is to say): An Act of the session
holden in the thirty-ninth and fortieth years of King George
the Third, chapter 94; an Act of the session holden in the
first and second years of her Majesty, chapter 14; and an Act
of the session holden in the third and fourth years of her Ma-
jesty, chapter 54, or any other provisions concerning criminal
lunatics, save as hereinafter provided ; that is to say, it shall
* Vide 25 & 26 Vict. c.111, s.47. By this it is seen that the
medical man must be registered according to the Medical Act.
Lunacy act, 1853: 16 &17 vicr.c. 96 375
be lawful for one of her Majesty’s principal Secretaries of
State to issue his warrant to remove or discharge any insane
person who shall be in custody under the provisions of the said
Act of the third and fourth years of her Majesty, chapter 54,
provided it shall be duly certified to such Secretary of State,
by two physicians or surgeons, that such.insane person was
harmless, and might be discharged from restraint as an insane
person, without danger to himself or to others, in like manner
as if it had been certified to such Secretary of State that such
person had become of sound mind, anything in the said Act or
any other Act to the contrary thereof in any wise notwith-
standing.
39. And whereas by the said recited Act it is provided that
every person to be appointed in the room of any Commissionér,
being a barrister of five years’ standing at the bar and upwards,
shall be a practising barrister of not less than five years’ standing
at the bar: And whereas it is expedient to amend the said pro-
visions as hereinafter mentioned ; the present or any future.
. secretary to the Commissioners, if at the time of his appoint-
ment to be such secretary he was or shall have been a prac-
tising barrister of not less than five years’ standing at the bar,
shall be eligible to be appointed a Commissioner in the room of
any such Commissioner as aforesaid.
40, This Act shall commence and come into operation on
the first day of November, 1853.
Secretary to
the Commis-
sioners, if at
the time of
his appoint-
ment a
practising
barrister of
five years’
standing,
eligible to
be appointed
a Commis-
sioner.
Commence-
ment of Act.
376 MANUAL OF LUNACY
Schedules to the foregoing Act.
SCHEDULE (A) No. 1, Seerions 4, 8.*
Order for the Reception of a Private Patient.
I, the andersigned, hereby request you to receive A.B., a Lunatic
[or an idiot, or a person of unsound mind,] as a patient into your
house [or hospital}. Subjoined is a statement respecting the said
(Signed) Name.
Occupation (if any),
Place of abode.
‘ Degree of relationship (if any), or other
circumstance of connection with the
patient.
Dated this day of One thousand eight
hundred and : :
To Proprietor [or Superintendent] of
[describing the house or hospital by situation and name, if any}.
STATEMENT.
[f any particulars in this Statement be not known, the fact to be so
stated.]
Name of patient, with Christian name at length.
Sex and age.
Married, single, or widowed.
Condition of life, and previous occupation (if any).
The religious persuasion, as far as known.
Previous place of abode.
Whether first attack.
Age (if known) on first attack.
When and where previously under care and treatment.
Duration of existing attack. .
Supposed cause. ~
Whether subject to epilepsy.
Whether suicidal.
Whether dangerous to others.
* Vide 25 & 26 Vict. c. 111, ss. 28, 25, 26. By the amended
Act we see that the order is only available for one month, and the
person signing it must have seen the patient within a month,
Lunacy act, 1853: 16 & 17 vier. ©. 96 377
Whether found lunatic by inquisition, and date of commission or
order for inquisition.
Special circumstances (if any) preventing the patient being exa-
mined, before admission, separately by two medical practi-
tioners,
(Signed) * Name.
[Where the person signing the Statement is not the person who signs
the Order, the following particulars concerning the person signing
the Statement are to be added ; viz.,
Occupation (if any).
Place of abode.
Degree of relationship (if any) or other circumstances of connection
with the patient:]
SCHEDULE (A) No. 2, Szctions 4, 5, 8, 10, 11, 12, 13.
Form of Medical Certificate.
I, the undersigned [here set forth the qualification entitling the
person certifying to practise as a Physician, Surgeon, or Apothecary,
ex. gra., being a Fellow of the Royal College of Physicians in Lon-
don], and being in actual practice as a [Physician, Surgeon, or
Apothecary, as the cuse may be], hereby certify, That I, on the
day of at [here insert
the street and number of the house (if any) or other like particulars},
in the county of , separately from any
other Medical Practitioner, personally examined A.B. of
[insert residence and profession or occupation, if any], and that the
said 4.B. is a lunatic [or an idiot, or a person of unsound mind],
and a proper person to be taken charge of and detained under care
and treatment, and that I have formed this opinion upon the follow-
ing grounds ; viz.
1. Facts indicating insanity observed by myself [here state the
Facts).
2. Other facts (if any) indicating insanity communicated to me
by others [here state the information, and from whom].
(Signed) +
Place of abode.
Dated this day of One thousand eight
hundred and é
* Vide 25 & 26 Vict. c. 111,5. 24. This will enumerate those who
are prohibited from signing.
T Vide 25 & 26 Vict. c. 111, 8, 24.
378 MANUAL OF LUNACY
SCHEDULE (B) No. 1, Szcrion 7.
Order for the Reception of a Pauper Patient.
I, C.D. [or, im the case of a Clergyman and Relieving Officer, &c.,
we, C.D. and HF], the undersigned, having called to my (or our)
assistance a Physician, [or Surgeon, or Apothecary, as the case may
be,] and having personally examined 4.B., a Pauper, and being
satisfied that the said A.B. 1s a Lunatic [or an Idiot, or a person of
unsound mind,] and a proper person to be taken charge of and
detained under care and treatment, hereby direct you to receive the
said A.B. as a patient into your house [or hospital]. Subjoined i isa
Statement respecting the said 4.B.
(Signed) C.D.
A Justice of the Peace for the County, City, or
Res
Borough of
[or an or the Officiating Clergyman of the Parish
of ].
(Signed) EF.
The Relieving Officer of the Union or Parish of
[or an Overseer of the Parish of
Dated the day of One thousand
eight hundred and ‘
To Proprietor [or Superintendent] of
[describing the house or hospital].
STATEMENT.
[Zf any particulars in this Statement be not known, to be so stated.]
Name of patient, and Christian name at length,
Sex and age. '
Married, single, or widowed.
Condition of life, and previous occupation (if any).
The religious persuasion, as far as known.
Previous place of abode.
Whether first attack.
Age (if known) on first attack.
‘When and where previously under care and treatment.
Duration of existing-attack.
Supposed cause.
Whether subject to epilepsy.
Whether suicidal.
LUNAcy act, 1853: 16 &17 vicr. c. 96 379
Whether dangerous to others.
Parish or Union to which the Lunatic is chargeable.
Name and Christian name and place of abode of nearest known
relative of the patient, and degree of relationship (if known).*
I certify that, to the best of my knowledge, the above parti-
culars are correctly stated.
(Signed)
Relieving Officer [or Overseer].
SCHEDULE (B) No. 2, Szcrrons 7, 10, 11, 12, 13.
Form of Medical Certificate.t
I, the undersigned [here set forth the qualification entitling the
person certifying to practise as a Physician, Surgeon, or Apothecary,
ex. gra., being a Fellow of the Royal College of Physicians in Lon-
don], and being in actual practice as a |Physician, Surgeon, or
Apothecary, as the case may be], hereby certify, that I, on the
day of at [here insert the
Street and Number of the House (uf any) or other like particulars], in
the County of » personally examined 4.B. of
[insert Residenee and Profession or Occupation
(# any), and that the said A.B. is a Lunatic, [or an Idiot, or a
Person of Unsound Mind], and a proper person to be taken charge
of and detained under care and treatment, and that I have formed
this opinion upon the following grounds ; viz.—
1. Facts indicating Insanity observed by myself [here state the
facts).
2. Other Facts (if any) indicating Insanity communicated to me
by others [here state the information, and from whom].
(Signed)
Place of Abode.
Dated this day of One thousand
eight hundred and .
* Vide 25 & 26 Vict. ¢. 111, s. 25.
+ Vide 25 & 26 Vict. c. 111, ss. 26-27.
+ Vide 8 & 9 Vict. c. 100, s. 23.
380 MANUAL OF LUNACY
SCHEDULE (C) Szcrion 24.
Notice or ApMIssion,
I uerepy give you Notice, that 4.B. was admitted into this
House [or Hospital] as a Private [or Pauper] Patient on the
day of and I hereby transmit a Copy of the Order and ,
Medical Certificates [or Certificate] on which he was received. [if
a Private Patient be received upon One Certificate only, the special
Circumstances which have prevented the Patient from being examined
by Two Medical Practitionere to be here stated, as in the Statement
accompanying the Order for Admission].
Subjoined is a Statement with respect to the mental and bodily
Condition of the above-named Patient.
(Signed)
Superintendent [or Proprietor] of
Dated the * day of One thousand eight
hundred and :
STATEMENT.
I have this Day [some Day not less than Two clear Days after the
Admission of the Patient] seen and examined
the Patient mentioned in the above Notice, and hereby certify that
with respect to mental State he [or she] and that
with respect to bodily Health and Condition he [or she]
(Signed)
Medical Proprietor [on Superintendent, or Attendant] of
Dated the* day of One thousand
eight hundred and
* Vide 8 & 9 Vict. c. 100, s, 52; 25 & 26 Vict. c. 111, 8, 28.
This notice must be sent within one clear day, and the statement
after the expiration of two and before the expiration of seven.
16 & 17 vict. co. 96 381
LUNACY. act, 1853
Aue 4se[ 044
‘ souls syuelyeg
% eouaTorA
pus ‘serinfuy
‘sqgeeq
seemeg | soreyr | soremeg | soreyl sepeweg , Soler “aT ‘Ww “a ‘WwW
xapasostp ApIpoq uoysnyoag 7 qurerzqsoy sadn OVA
(4us 71) =
qeyA Joy pus
‘quataqeeLy, 1eOrpayT
depun syueneg
suveul yen
Insert Parish or Township.
2 Insert Physician, Surgeon, or Apothecary, ° County or Borough. '
as the case may be. ® Name of Union.
3 Name of Pauper. 7 Or the day of the hearing.
406 MANUAL OF LUNACY
‘ 16 & 17 Vict. c. 97,8.89. Schedule F. No.4. (8,)
NOTICE OF ADMISSION OF A PAUPER PATIENT.
'
I HEREBY GIVE you Nortics, That! |
was admitted into this Asylum as a Pauper Patient, on the
day of 18 , and I hereby transmit a Copy of
the Order and Statement and Medical Certificate on which? he was
received.
Subjoined: is a Statement with respect to the Mental and Bodily
Condition of the above-named Patient,
(Signed) .
Clerk of Asylum.
Dated this day of
One thousand eight hundred and
To the Commissioners in Lunacy.
STATEMENT.
I have this day* seen and examined?
the Patient mentioned in the above Notice, and hereby Certify, that
with respect to Mental State? he
and that with respect to Bodily Health and Condition? he
(Signed)
Medical Officer of Asylum.
Dated this day of
One thousand eight hundred and
1 Here insert the Patient’s name.
2 Insert she where necessary.
* Some day not less than éwo nor more than seven clear days after the admis-
sion of the Patient.
Note.—The 16 & 17 Vict. c. 97 requires the Clerk of the Asylum, after the
second and before the end of the seventh clear day from the day of the admis-
sion of the Lunatic into the Asylum, to transmit this document to the
Commissioners in Lunacy, subject to a penalty of 201. for his omission,
ORDER FOR ADMISSION OF PAUPER LUNATIC 407
16 & 17 Vict. c. 97, 8,73. Sched. (F.) No. 1.
COPY OF THE ORDER FOR THE RECEPTION OF A
PAUPER PATIENT,
1
the undersigned, having called to? Assistance a?
and having personally examined
a Pauper,‘ and being satisfied that the said
is a &
: . and a proper person to be taken charge of
and detained under Care and Treatment, hereby direct you to re-
ceive the said asa
Patient into your Asylum.
Subjoined is a Statement respecting the said
(Signed)
Dated the day of One
thousand eight hundred ‘and
To
Superintendent of the Asylum for the
of
1 I, C. D., a justice of the peace for the county, city, or borough of -—; or
in case of two justices, or of a clergyman and relieving officer, or overseery We,
C. D., and £, F.
2 My or our.
* Physician, or surgeon, or apothecary, as the case may be.
* Omit the words a pauper, when the lunatic is not a pauper.
* Lunatic, or an idiot, 0” a person of unsound mind.
© Add, where the lunatic is sentas being wandering at large, the words wandering
at large, and in the case of a lunatic sent by virtue of the authority given to two
justices, add not under proper care and control, or and is cruelly treated or neg-
lected by the person having the care or charge of him, as may appear to the jus-
tices to be the case.
7 Justices of the peace for the county or borough of —— ; or an or the offi-
ciating clergyman of the parish of ——. To be signed by two justices where re-
quired by the Act. ~
8 The relieving officer of the union or parish of ——, or an overseer of the
parish of ——. .
® State the special circumstances (if any) in the blank space. .
Where the order directs the lunatic to be received into any asylum other than gn
408 ‘ MANUAL OF LUNACY
STATEMENT. :
If any Particulars in this Statement be not known, the Fact’
to be so stated.
Name of Patient, and ey
Name, at length ..
Sex and Age :
Married, Single, or Widowed
Condition of Life, and te
Occupation (if any) .
The Religious Persuasion, as —
as known . ,
Previous Place of Abode
Whether first Attack . ‘ F
Age (if known) on first Attack .
When and where previously
under Care and Treatment
Duration of existing Attack .
Supposed Cause . .
Whether subject to Epllopay
Whether Suicidal . : =
Whether Dangerous to others
Parish or Union to which ra
Lunatic is chargeable (if a
Pauper. or destitute Lunatic)
Name and Christian Name, and
Place of Abode of nearest
known relative of the Patient,
and degree of Relationship
(ifknown) . .
I Certify that, to the best of my knowledge, the above par-
ticulars are correctly stated,
(Signed)
asylum of the county or borough in which the parish or place from which the lunatic
ts sent ts situate, or into a registered hospital or licensed house, it should state that
the jdstice or justices, or other persons making the order, is or are satisfied that there
is no asylum of such county or borough, or that the asylum or asylums thereof is or
are full; or (as the case may require) the special.circumstances by reason whereof
the lunatic cannot nneenne be taken to an asylum for such first-mentioned county
or borough.
MEDICAL CERTIFICATE FOR PAUPER LUNATIC 409
16 & 17 Vict. c. 97, 8.73. Sched. (F.) No. 3.
COPY OF THE MEDICAL CERTIFICATE.
I, the undersigned, being a}
and being in actual Practice as a? hereby Cortify,
that I, on the day of at?
4 in the County of
4
personally examined 5
and that the said
is at and a proper Person to be
taken charge of and detained under Care and Treatment, and that
I have formed this opinion upon the following grounds ; viz.i—
1, Facts indicating Insanity observed by myself?7—
2. Other Facts indicating Insanity communicated to me by -
others®
(Signed)
Place of Abode
Dated this day of One
thousand eight hundred and
* Here set forth the qualification entitling the person certifying to practise asa
physician, surgeon, or apothecary, e.g.:—Fellow of the Royal College of Physicians
in London, Licentiate of the Apothecaries’ Company, or as the case may be,
’ 2 Physician, surgeon, or apothecary, as the case may be.
% Here insert the street and number of house (if any) or other like particulars.
* In any case where more than one medica certificate is required by this Act, here
insert, separately from any other medica] practitioner. ; ;
5 A. B.of —. Insert residence, and profession or occupation (if any).
® Lunatic, or an idiot, or a person of unsound mind.
” Here state the facts.
* Here state the information (if any) and from whom,
410 MANUAL OF LUNACY
16 & 17 Vict. c. 97, 8.79. No, 41.
ORDER FOR DISCHARGE OF LUNATIC FROM ASYLUM
BY THE VISITORS THEREOF.
, |e the undersigned, being Justices of the Peace acting
f
in and for the! of and two of the
Visitors of the Lunatic Asylum situate at?
| in the! of DO HEREBY, with the
to wit. J advice in writing of the Medical Officer thereof, orpER
one® a Lunatic, now detained in the said Asylum:
to be discharged therefrom 4
Given under our Hands and Seals, this day of
in the year of our Lord One thousand eight hundred and
at in the aforesaid.
(z. 8.)
(L. Ss.)
1 County or Borough.
2 Place of Lunatic Asylum.
3 Name of Lunatic.
- Add forthwith, or on the day of
Certificate or Mepicat OFFICER.
I, the Medical Officer of the Lunatic Asylum at
in the? of from which it hath been proposed
that one a Lunatic, now detained in the said Asylum,
should be ordered by two of the Visitors of the said Asylum to be
discharged, DO HEREBY cERTIFY to such Justices that such Lunatic
in my judgment may be discharged from such Asylum.
As witness my Hand, this = day of at
{u. 5.)
ORDER FOR DISCHARGE OF PAUPER LUNATIC 411
8 & 9 Vict. c. 100, s. 74. No. 49.
ORDER FOR DISCHARGE OR REMOVAL OF A PAUPER
LUNATIC FROM A LICENSED HOUSE.
To} the? of the®
at‘ / in thes of
Sir,—I am directed by the Board of Guardians of the®
in the of to transmit to you a Copy
of a Minute of the Board respecting a Pauper Lunatic now confined
in your’ and to request that the same may receive due
attention from you.
Iam,
Yours truly,
Clerk to the said Guardians.*
Dated-this day of
* Insert Name. “ Insert Name of Place,
® Proprietor or Superintendent. 5 County or Borough.
® Licensed House or Registered Hospital. ® Insert Union or Parish.
* Upon receipt of a Copy of this Minute, the Proprietor or Superintendent shall
forthwith discharge or remove such Patient, or cause or suffer such Patient
to be removed, unless the Physician, Surgeon, or Apothecary keeping the
same, or the regular Medical attendant thereof, in writing under his hand,
eertify that in his opinion such Patientis dangerous and unfit to be at
large, together with the grounds on which such opinion is founded. 8 & 9
Vict. c. 100, ss. 74, 75.
Copy or A Minute oF THE BoarD oF GUARDIANS OF THE
Dated the day of
Resolved,—That? a Pauper Lunatic belonging
to this® and now detained in the at’
in the of shall be forthwith
$ therefrom, and that? be’ in the manner
following: that is to say—'®
(signed)
Presiding Chairman.
7™ Name of Lunatic. * He or she.
° Removed or discharged. 10 Here set out the mode.of discharge or removal.
412 MANDAL OF LUNACY
16 & 17 Vict. c. 97,8. 68, No. 22.
INFORMATION AS TO A LUNATIC WANDERING AT
LARGE.
Tae Inrormarion of! of?
of in the* of taken upon
oath before me, the undersigned, one of Her Majesty’s
Justices of the Peace acting in and for the®
to wit. J of this day and year underwritten, who
informeth me that one* is wandering at large
within the limits of my jurisdiction, that is to say, within the®
of and is deemed to be a Lunatic.
Wueneroxse the said Informant applies to me to issue my Order,
under my Hand and Seal, in such behalf, according to the Statute in
such case made and provided,
Sworn before me, this day of in the year of our
Lord One thousand eight hundred and at
in the’ of
1 Insert name of Informant.
2 His place of abode.
* Insert County or Borough.
* Name of Lunatic.
16 & 17 Vict. c. 97, 5.68. No. 23.
ORDER OF JUSTICE TO BRING A WANDERING
LUNATIC BEFORE HIM.
$ To} of? in
the® of | the*
of of thes of
‘Warreas one® of - hath this
to wit. J day appeared before me, the undersigned, one of Her
Majesty's Justices of the Peace acting in and for the’ of
and upon his oath hath informed me that one®
ig wandering at large within the limits of my jurisdiction,
that is to say, within the® of and is deemed to
be a Lunatic.
THIS THEREFORE is to require you forthwith to apprehend the said
and bring’ before me, or before some other
Justice having jurisdiction in the said® if the said
WANDERING LUNATIC EXAMINED 413
shall be apprehended therein, to be dealt with as the aw
may require.
And this shall be your sufficient warrant.
Given under my Hand and Seal, this day of in
the year of our Lord One thousand eight hundred and
at in the
(L. 8
* Insert name of Person to whom Order is addressed.
* Place of his abode.
5 County or Borough.
* Constable, Relieving Officer, 07 Overseer of the Poor.
> Parish or Township.
* Insert from the Information.
7 Insert him or her as the case may require.
16 & 17 Vict. c. 97, s. 68. No. 24.
REQUEST OF JUSTICE TO MEDICAL PRACTITIONER
TO ASSIST HIM IN THE EXAMINATION OF A WAN-
DERING LUNATIC. ‘ ‘
To! of =
Sir—Wuereas Information having been made before me, on
oath, that one® wandering at large within the
limits of my jurisdiction, is deemed to be a Lunatic, I have, by an
Order under my Hand and Seal, ordered him to be brought before
me, at : in the , or before
some other Justices having jurisdiction in the said‘ to be
dealt with as the law may require: I po THEREFORE hereby request
you to attend before me, or such other Justices, at the time and
place-aforesaid, to examine such alleged’ Lunatic, and to render me
or them every assistance in your power in relation to the matter
aforesaid.
Ian,
Your obedient servant,
1 Insert name of Medical Practitioner.
* Insert Physician, Surgeon, or Apothecary, as the case may be.
= Name of Lunatic.
* Insert County or Borough.
414 MANUAL OF LUNACY
16 & 17 Vict. c, 97, 8. 68. No. 25.
INFORMATION AS TO A LUNATIC NOT UNDER PROPER
CARE AND CONTROL, OR CRUELLY TREATED OR
NEGLECTED.
*) Taz Invormarion of} of
[the? of the? of j, in
the of given upon oath before me,
the undersigned, one of Her Majesty’s Justices of the
to wit. J Peace acting in and for the said‘ the day and
year underwritten, who informeth me that ones
of the said ® in the‘ aforesaid, and within the
limits of my jurisdiction, not a Pauper, and not a Person wandering
at large, is deemed to be a Lunatic, and is®
~ of
Waererore the said Informant applies to me to inquire into the
matters aforesaid, and deal with the same as the case shall appear
to me to require.
Sworn before me,.this _ day of in the year of our
Lord One thousand eight hundred and at
in the
1 Insert name of the Informant.
2 Insert Constable, Relieving Officer, o7 Overseer, as the case may be; or if any
other person give information, erase the words within the brackets.
3 Insert Parish or Township.
* County or Borough.
5 Name of Lunatic.
© Insert, as the case may be, not under proper care and control; or cruelly
treated by his (or her) relative, or by the person having the care or charge of
him or her}; or neglected by his (or her) relative, or by the person having the
care or charge of him (or her).
16 & 17 Vict. c. 97, 8. 68. No, 27.
ORDER OF JUSTICE TO BRING LUNATIC, NOT A
PAUPER, BUT ALLEGED TO BE NEGLECTED OR
ILL-TREATED BEFORE TWO JUSTICES.
. To!
ee of? in the*
of the*
: of the of
to wit. J in the’ of
Wuereas Information having been given before me, the under-
signed, one of Her Majesty's Justices of the Peace acting in and
ORDER OF JUSTICE TO EXAMINE LUNATIC 415
for the® of
on oath
that one® of
the’ of in
the‘ of and with-
in the limits of my jurisdiction, not a Pauper, and not a person
wandering at large, was deemed to be a Lunatic, and was®
I did by an Order under my Hand
and Seal, bearing date’
: order one® :
being a® to visit and examine the said®
; and make inquiry into the matters
aforesaid, and report to me his opinion thereon. AND wuerRzas the
said® hath visited and examined the said®
and made inquiry into
such matters, and hath reported to me in writing his opinion there-
on. AND WHEREAS upon such report it appears to me that the
matters of such Information are true.
Now tuererors I do hereby order you to take the said®
; and bring? before two Justices,
at 5 in the® aforesaid, on the
‘ day of there to be dealt with as the law shall require.
Grven under my Hand, this day of
fn the year of our Lord One thousand eight hundred
and at
in the
(1.8.)
1 Name of person to whom the Order is to be addressed.
2 Place of his abode.
% County or Borough.
* Constable, Relieving Officer, o Overseer of the Poor.
® Parish or Township.
* Name of Lunatic.
” Place of his abode.
® Insert, as the case may be, not under proper care and control; or cruelly
treated by his (or her) relative, or the person having the care or control of him
(or her) ; or neglected by his (or her) relative, or by the person having the care
or control of him (or her).
° Insert Physician, Surgeon, or Apothecary, from the Order.
10" Insert him or her.
416 MANUAL OF LUNACY
16 & 17 Vict. c. 97, 8. 68. No, 26.
ORDER OF A JUSTICE TO A MEDICAL PRACTITIONER
TO VISIT A LUNATIC ALLEGED TO BE ILL-TREATED
OR NEGLECTED,
3 To! :
, of? ‘ in the’
of of ‘
Wuereas Information hath this day been given before
to wit. J me, the undersigned, one of Her Majesty’s Justices of
the Peace acting in and for the* of
on oath, that one®
of the® of in thes
of and within the limits of
my jurisdiction, not a Pauper, and not a person wandering at large,
is deemed to be a Lunatic, and is”
Now THERerore I do hereby Order you to visit and examine
such Person and make inquiry into the matters aforesaid, and to re-
port in writing to.me your opinion thereupon with all due speed,
and for your so doing this shall be your sufficient authority.
Given under my Hand and Seal, this day of
‘ in the year of our Lord One thousand eight
hundred and at
in the of
. (z.8.)
» Name of Physician, Surgeon, o7 Apothecary.
2 Place of his residence.
* County or Borough,
* Insert here Physician, Surgeon, ov Apothecary, us the case may bé.
5 Name of Lunatic.
* Parish or Township. .
Insert, as the case may be, not under proper care and control; or cruelly
treated by his (o7 her) relative, or by the person having the care or charge of
him (or her) ; or neglected by his (07 her) relative, or by the person having the
care or charge of him (or her).
LUNATIC ALLEGED TO BE ILL-TREATED Al7
16 & 17 Vict. c. 97,8, 68. No. 28.
REQUEST OF TWO JUSTICES TO MEDICAL PRACTI-
TIONERS TO ASSIST THEM IN THE EXAMINATION
OF A LUNATIC ALLEGED TO BE ILL-TREATED OR
NEGLECTED.
To!
of? . ce
Sir,
Wuernas * one of Her
Majesty's Justices of the Peace acting in and for the :
of ; having, after information
on oath before him that one®
of? ‘ deemed to
be a Lunatic, was®
and after due enquiry into the matters of such information, ordered
the said® to be
brought before us, the undersigned, Justices of the Peace for the
said § on at
: in the said there to be
dealt with as the law shall require.
We Do THEREFORE hereby request you to attend before us, at
. the time aforesaid, to examine such alleged Lunatic, and to render
us all the assistance in your power in relation to the matter afore-
paid.
We are,
Your obedient servants,
1 Insert name of Medical Practitioner.
* His abode.
> Physician, Surgeon, o7 Apothecary.
* Insert name of Justice; if one of those signing this Request, insert, I, the under-
signed, A. B.
* County or Borough.
© Name of Lunatic.
” Place of his abode.
> Insert, as the case may be, not under proper care and control; or crueliy
trtated by his (or her) relative, or by the person having the care or control of
him (or her) ; 07 neglected by his (07 her) relative, 07 by the person having the
care or control of him (07 her).
EE
418 MANUAL OF LUNACY
16 & 17 Vict. c. 97, 8.77. No. 40.
ORDER FOR REMOVAL OF PAUPER LUNATIC TO AN
ASYLUM BY THE VISITORS THEREOF.
4) To!
of
of the? , of the®
to wit. J We, the undersigned, being Justices of the Peace acting
in and for the of .
and two of the visitors of the Lunatic Asylum, situate at®
in the 4 of
‘ and belonging ® to the
said‘ DO HEREBY ORDER YOU, With all due speed, to
remove one’
a Pauper Lunatic chargeable to the aforesaid, and now
confined in the® of
to the said Asylum at®
Given under our Hands and Seals, this day
of in the year of our Lord One thousand
eight hundred and at
in the aforesaid.
(L.s.)
(1.8.):
1 Name of Officer. © Place of Lunatic Asylum.
? Overseer, Relieving Officer, or other Officer. * Add wholly or in part.
» Union, Parish, or County. 7 Name of Lunatic.
* County, or Borough. * Asylum, Registered Hospital, or Licensed House.
Certiricate or Mzpicat OFFicer.
I, the Medical Officer of the Lunatic Asylum at
: in the of
from which one
a Pauper Lunatic, now in the said Asylum, hath been ordered by
two of the visitors of the Pauper Lunatic Asylum at
in the* of
to be removed thereto, Do HEREBY CERTIFY that such Lunatic is in
a fit condition of bodily health to be removed, in pursuance of such
Order. ‘
-As witness my Hand, this day of
18 at
(z.s.)
INDEX.
A
ABSENCE,
leave of, granted to private patients from asylums, 53, 335, 396
of pauper patients, 99
ACTIONS,
for illegal detention of a single patient, 88, 89
for reception of a lunatic without medical certificate, 161
against the person who signed the order, 163-165 ;
against a non-registered practitioner for signing a certificate,
168, 169
brought against proprietor, what may be pleaded in, 341, 342
limitation of, 345
for wilfully obstructing orders of Commissioners, Lord Chan-
cellor, or Secretary of State, 373
ACTS,
Lunacy Act, 8, 9 Vict. v. 100 (1845), 299- 360
» » 16,17 Vict. c. 96 (1853), 361-378
Amendment Act, 25, 26 Vict. c. 111 (1862), 382-401
copy of (1845) to be bound up in Visitors’ Book, 327-874
section in Vagrant (1744), 7
ADMISSION,
of private patients into asylums, 41, 56-81
instructions by Commissioners, relative to, 252-256
order for, 56-59, 252, 254, 376
notice of, sent to Commissioners, 44, 356
form of, 370
of Chancery patients into asylums, 139, 391
of single patients into unlicensed houses, 82-89, 336, 364
», Chancery lunatics into unlicensed houses, 133, 336
of Pauper lunatics into county asylums, 94-97
licensed houses, 100, 390, 364
BE2
Py oe
420 INDEX
ADMISSION—(continued),
of pauper lunatics into workhouses, 101
book kept at asylums of, 42, 319, 354
into St. Luke’s Hospital, regulations concerning, 140-151
into Bethlehem 5 rr 152-159
into asylums in Ireland, 190-192
notice of, sent to Inspectors, 193
of patients into asylums in Scotland, 170-172
notice of, 173
into asylums in France, 205, 206
5 Belgium, 215-217
notice of, 216
into asylums in Germany, 233
AFFIDAVIT,
of relatives of alleged lunatics.in support of Commission, 114
of medical man previous to Commission, 115
form of, 115
how to be drawn up, 114
made concerning the Committees and their respectability, 125
ALLEGED LUNATICS, visitation of, 339, 373
AMENDMENT of defective certificates, order, and statement, 66,
254, 365, 392
AMERICA,
lunacy in, 243
list of asylums in, 244, 245
APOTHECARY, '
old meaning of term, 13
to be registered, 399 :
APPEAL to Quarter Sessions in event of conviction by Justice, 345
ASYLUMS,
in the olden time, 9,11, 18 ‘ i
on the present management of, 41-55
discharge of dangerous patients prohibited from, 33, 331
residence of licensee in, 38, 361, 389
medical officer in, 39, 319, 350
licence for, 84, 306, 308
admission of private patients into, 41
pauper patients in, 96-97, 100
Chancery patients in, 139
books to be kept in, 42
list of metropolitan private asylums, 77, 78
» provincial Si ‘5 79 -81
» county and borough _,, 107-110
visitation by Commissioners of, 32, 324, 393
INDEX 42}.
ASYLUMS—(continued),
remarks by Commissioners on private asylums, 258-260
rendered unfit for use by fire, or otherwise, 317
visitation of, beyond the jurisdiction of Commissioners’, 326
how defined, 350
superannuation of officers in, 386
inspection of by Commissioners before granting licences, 388
alterations in, 388
transfer of patients from, 47, 317, 368
discharge of patients from, 44, 330, 398
death of patients in, 45, 321, 324
illegal grounds for detaining patients in, 41
escape of patients from, 46, 320, 335, 336
correspondencé of patients in, 51, 397
ill-treatment or neglect of patients in, 51, 368
visitation of patients by friends in, 52,
leave of absence from, 53, 335, 396
boarders in, 48-50, 368, 390
plans for, 309, 311, 312
Commissioners’ may order removal from, 331
night visitation by Commissioners of, 32, 330
alteration of buildings, 312
. insufficient accommodation in, 98, 99
medical certificates for admission into, 63-77, 362
order : 3 56-59, 362
statement 5 59-63, 320
attendants in, ,, i 53,374
Scotland, 174; Ireland, licence for asylums in, 190,
order, statement, and medical certificate for transfer into,
190-192; in Scotland, 170, 172
book kept at, 194
visitation of, 195
escape of patients from, 194, 195 .
public asylums in Ireland, 201, 202; in Scotland, 188, 189
private ,, » 199, 200; — > 186, 187
Order of sheriff for admission of patients into asylums in Scot-
land, 172 ’
licence for asylums in France, 204, 205
list of asylums in France, 210, 214
admission of patients into, 203, 206
licence for asylums in Belgium, 215
list of asylums in Belgium, 219-223
reception of patients into, 215, 216
Gormany, list of asylums in, 233, 241
422 INDEX
ASYLUMS—(continued),
America, list of asylums in, 244,245. (See also Licenssp
Hovszs.)
ATTENDANTS,
how defined in Act, 374
record of, to be kept by Commissioners, 55
notice of engagement and discharge of, 54
wages of, 55
penalty of, for ill-treating a patient, 51, 364
medical, of single patients, 83, 85, 336, 366
notice of dismissal sent to Commissioners, 64, 371
B
BARLOW, Mr. FRANCIS, Master in Lunacy, 29
BARRISTER,
Master in Lunacy, legal visitor, and Commissioner, required
to be a, 28 29, 301. (See also CommissionErs in Lunacy.)
what is meant in Act by a, 349
BELGIUM,
lunacy in, 215
licences for asylums in, 215
_Tegulations respecting asylums and admissions intoin, 215-218
list of asylums in, 219-223
statistics of insanity in, 229-232
BERLIN, asylums at and near, 236, 242
BETHLEHEM HOSPITAL,
particulars relative to admission of patients into, 152-159
origin and history of, 5, 6
subject to Act, 1853, 373
BIBLE, reference to insanity in the, 1
BOARDERS,
in asylums in England, and remarks by Commissioners on,
48-50, 363, 390.
provision in Act concerning, 363-390
in asylums in Scotland, 178
BOOKS,
“» of admission to be kept at asylum, 42, 319, 354
- inspection by Commissioners of, 45, 46, 319
official, to be placed before Commissioners in Lunacy, 48, 116,
327
Case Book, 42-44, 323
entries to be made in, 46, 323
notice of death to be entered in, 45, 321, 368
INDEX 423
BOOKS—(continved),
of discharge, entries made in, 44, 321
of visitors, Commissioners’ entries in, 46, 327
of patients, st is 46, 328
of medical visitation, for single patients, 85, 336, 398
of visitors of patients beyond the immediate jurisdiction of the
Commissioners, 31, 826, 327
in Ireland, 194
BOROUGH,
meaning of a, 349
Borough-rate, 350
what to include, $51
asylums in, 107-110
BRIDEWELL, origin of, 11
BUCKNILL, Dr. JOHN, Medical Chancery Visitor, 183
C
CAMPBELL, Mr. W. G., Legal Commissioner in Lunacy, 29
CASE BOOK, 42-44, 323
CERTIFICATES. (See Mepican Certiricats.)
CHANCERY LUNATICS, 111, 139
ancient mode of dealing with property of lunatics, 111, 112
protection of property by Crown, 113 :
restoration of property in the event of recovery, 113
two ways of dealing with the property of, 113
mode of procedure and object of Commission, 113
proceedings prior to Commissions de lunatico inquirendo, 113
forms of petition of Commission, 114
affidavit made in support of Commission, form of, 115
affidavits filed with registrar, 115
consent in writing to be obtained in certain cases, 116
Notice of Commission served on alleged lunatic, 116
when no jury is demanded, 117
Order for Commission signed by the Lord Chancellor or Lords .
Justices, 117
form of order for Commission, with or without j jury, 117
power given to the Court to refuse or grant the order, 118
expenses defrayed by petitioner, 118
eaveat to Commission, 118
form of caveat, 118
provisions relative to lunatics residing abroad or beyond the
jurisdiction of the court, 119, 120
place for holding the Commission, 120
424 . INDEX
CHANCERY LUNATICS—(continued),
evidence relative to the insanity, 120
witnesses summoned to attend Commission, 120
form of summons, 121
evidence at Commission, and what is admissible as such, 121
right of the lunatic to be present at Commission, -122
Master, if doubtful, may have assistance of a jury, 122
evidence of witnesses residing abroad, 122
mode of Commission and verdict, 122, 123
appointment of Committees, 123
proceedings subsequent to enquiry, 124, 125
Committees who are preferred to act, 125
duties of Committees of the Person, 126, 127
i Estate, 127, 128
death or retirement of Committees, 129, 130
proposal for appointment of new Committees, 130
proceedings on death of lunatic, 130
power of Master to deal with documents deposited at his office,
130 4
dealing with property less than 1002. per annum, form of Com-
mission, 131, 132
section of Lunacy Regulation Act referring to it, 131,132
single Chancery patients, 133
Lord Chancellors’ Visitors of persons found lunatic by inqui-
sition, 133
salary of, 133
only hold appointments during good behaviour, 134
dealing with property of persons beyond the jurisdiction of the
Court, 134, 135
supersedeas of inquisition, form of, 136, 137
traverse of inquisition, 137, 138
form of traverse, 138
reception of Chancery patients into licensed houses—regula-
tions, 139, 391
CHARGES,
for licence, 38
for patients in County and Borough asylums, 107-110
ay at Gheel, 225
i at private asylums in Berlin, 237-242
i in asylums in America, 244, 245
CLEATON, Mr. J. D., Medical Commissioner in Lunacy, 29
COMMISSIONS IN LUNACY, 111-139. (See Cuancery Luna-
TICs.)
COMMISSIONERS IN LUNACY,
Lunacy Act, 1778, appointment by College of Physicians, 10
INDEX :
COMMISSIONERS IN LUNACY—(eontinued),
Lunacy Act, 1828, appointment of, 14
report of 1840, 16 '
c 1872, 19
names of, 29
salary of, 29,°301
prohibited from practice, 29, 301
appointment of, 29, 300, 301
seal of, 29, 303
jurisdiction of, 30, 306
secretary of, 29, 304, 375
entries made at visitation of, 31, 46, 327, 395
visitation by, 32, 324, 393
enquiries at visit of, 32, 326, 327
night visitation by, 32, 330 ‘
protection of property by, 33, 339, 370
discharge of dangerous patients by, 33, 331
licence granted, by, 34, 311, 313
remarks by, in 13th report, 1859, on licence, 34-37 |
additional remarks on licence, 1860, 37, 38
copies of medical certificate, statement, and notice of discharge
sent, to, 44, 401
approval of the resident licensee by, 38
remarks on Case Book by, 42-44
books examined by at time of official visit to aeyuinay 45, 46, 327
remarks by, on boarders in asylums, 48-50, 363, 390
leave of absence granted by, 53, 335
record of attendants, kept by, 55
remarks of in 15th report on medical certificates, 64-66
discharge of patient by, in consequence of insufficient facts in
certificate, 69-71, 392
instructions respecting medical certificates issued by, 76, “ip
252-256
visitation of single patients by, 84, 366
notice of death to be sent to, 45, 321
printed circular relative to single patients issued by, 84-87
prosecution by, in consequence of illegal detention, 88, 89
opinion of counsel taken by, in reference to single patients, 89-92
discharge of patient illegally certified by, 166-168
visitation of Chancery patients by, 133
in Scotland, list of, 181, 182
inIreland, ,, 198
in France, » 214
changes in during past year, 256
oath taken by, 303
426 INDEX
COMMISSIONERS IN LUNACY—(continued),
election of chairman, 303
quarterly meetings held by, 307
provision for special meetings, 307
power of any five to make rules, 329
» ealing with doubtful cases of insanity, 329
discharge of patients by, 331
visitation of asylums by two members of the Board with re-
ference to patients detained without sufficient cause, 332
permission for visitation of lunatic given by, 338 -
report to the Lord Chancellor by, 336
witnesses summoned by, 342
power to prosecute by, 346
to visit gaols and workhouses, 347, 393
may make regulations for the government of licensed houses, 372
COMMITTEE,
of House of Commons, 1763, 7
‘j 1814, 1816, 12
of Poneok preference given to next of kin to act, 125
to reside within jurisdiction of Lord Chancellor, 125 ‘
security given by, 125
appointment of, 126
custody of lunatic under charge of, 126
duties of, 126, 127
death of, 129, 130
of Estate, preference given to heir-at-law to act as, 125
to reside within jurisdiction of Lord Chancellor, 125
security given by, 125
appointment of, 127
estate and property of lunatic under care of, 128, 129
death of, 129, 130
duties of, 128, 129
CONSENT,
of Commissioners for discharge of dangerous lunatic, 33, 331
9 transfer of patients, 47, 48, 331
es ringle. patients, 86, 368, 360
for siinival of patient for benefit of health, 53, 335, 396
of Commissioners for new wings, or addition to asylum, 312, 388
COPIES,
of order and medical certificates preserved by Secretary of
Commissioners, 338
correspondence of patients in asylums, 51, 397
COUNSEL, opinion taken in reference to certain matters relative to
single patients, 89-92
INDEX 427
COUNTY,
meaning of, 349
what to include, 351
County asylum, establishment of, 383
proceedings prior to admission of pauper patients into County
asylum, 94
section of Act specially referring to, 96, 97
insufficient accommodation in, 98, 99
asylums in, list of, 107, 110
costs in, 109, 110
COXE, Sir JAMES, Commissioner in Lunacy for Scotland, 181
CRIMINAL LUNATICS, visitation of, 348
D
DANGEROUS LUNATICS,
consent of Commissioners obtained previous to discharge of, 33,
331
detention of in workhouses, 101, 102, 264, 390
in France, special provision for, 206
DEATH,
‘register of, 357
of licensee, 39, 316
of patient, notice of, 45, 321, 368 :
of the person who signed order of admission, 57, 330
of Committee, 129, 130
of single patient, 87, 398
of pauper patient, 99, 368
of patient in Scotland, 178
of Chancery lunatic, 130
form of notice of private patients, 358
entries concerning, 368
DELIRIUM, 283, 284
DELUSION, 281
DEMENTIA, 274
DIPSOMANIA, 284-288
DISCHARGE
of private patients from asylums, 44, 330, 398
of dangerous lunatics prohibited, 33, 331
of patients by Commissioners, 33, 329, 392
notice sent to Commissioners of, 44, 358
of attendants from asylum, 54
of single patient, 85, 87, 369
of pauper lunatic by Visitors, 99, 330
from licensed house, 101, 411
” ”
428 INDEX.
DISCHARGE—-(continued),
by Commissioners for illegality in certificate, 166, 167
registry of, 357
of patient from asylum in Scotland, 176
” a Treland, 195
” ” Belgium, 217
E
ENQUIRIES,
made by Commissioners at time of visit, 32, 326, 327
for persons of unsound mind in asylums, 52, 334
ENTRIES,
in Case Book, 42-44, 323
in medical journal, 45, 366
in official books by Commissioners, 46, 327, 395
5 Visitors, 31, 46, 395
in sdciiseto book, 42, 319, 354
in medical visitation book of single patients, 85, 336, 398
in book of discharges and deaths, +4, 45, 321
of death of patient in Case Book, 45, 368
concerning patients in Ireland, 193, 194
4 Scotland, 176-178
ESCAPE: OF PATIENTS FROM ASYLUM,
particulars relative to, 46, 320, 321, 335
i “3 in Ireland, 194, 195
penalty for conniving at, 397
ESQUIROL on dipsomania, 286
ESTATE OF LUNATIC. (See Commirrex or and Caancury Lv-
NATICS.)
F
FALSE CERTIFICATES, a misdemeanour, 366
FALSE ENTRIES IN OFFICIAL BOOK, a misdemeanour, 319,
321, 336
FEIGNED INSANITY, 294-297
(FORM) OF LICENCE, 353 :
FORSTER, Mr. JOHN N., Hon. Commissioner in Lunacy, 29, 257
FORTESCUE, Hon. D. F. 3 ‘i 29
FRANCE,
Tunacy in, 203-214
departments to contain asylums, 203
regulations concerning asylums, 203, 204
medical superintendent, 204
INDEX 429
FRANCE—(continued ),
licence for asylums, 204, 205
“ voluntary” patients, 205, 206
« judicial” lunatics, 206
dangerous lunatic, 206
investigation of alleged cases of insanity in, 208s 207
statistics of insanity in, 208, 210
list of asylums in, 210, 214
Commissioners of Lunacy in, 214
FRIENDS OF LUNATICS, particulars relative to boarding in
licensed houses, 363
FRIENDS, visit of, 52, 58, 334, 335 : ‘
G
GAOLS, visitation by Commissioners, 347, 393
GENERAL PARALYSIS OF THE INSANE, 293, 294
GERMANY,
licence for asylums in, -233
list of asylums in, 233-236
asylums in Berlin, 236-241
statistics of insanity in, 242
GHEEL, insane colony of, particulars relative to, 224-229
GUARDIANS,
discharge of pauper lunatic by, from licensed house, 100
notice of recovery sent to, 368
H
HALLUCINATION, 281
HATCHELL, Dr. G. W., Commissioner in Lunacy for Ireland, 198
HEALTH,
temporary leave of absence for patients, 53, 335, 396
leave of absence for single patients for, 86, 369
_ pauper lunatic leave of absence for, 99, 335
HOME SECRETARY may order visitation of lunatic, 348
HOMICIDAL INSANITY, 288
HOSPITALS FOR THE INSANE,
meaning of, 351
to have printed regulations, 319
regulations submitted to Secretary of State, 372 %
leave of absence from, 396 ©
HOUSES FOR RECEPTION OF LUNATICS. (See Licexsrp
Hovszs and AsyLums.)
HOWARD, Hon. G., Legal Commissioner of Lunacy, 29, 2.17
430 INDEX ;
I
IDIOTS,
distinguished from lunatics, 112
description of, 275-8 :
protection of property of by Crown, 113
IDIOCY, 275-278
ILL-TREATMENT OF PATIENTS,
in licensed houses, 51, 364
of lunatics wandering at large, 103, 414
prosecution for, 322
ILLUSION, 281
IMBECILITY, 275
INCOME OF LUNATICS, dealing with. ‘(See Cuancery Lunatics.)
INJURIES TO PATIENTS, entry to be made respecting in
medical journal, 45, 323
INQUISITION.- (See Cuancery Lunatics, 111-139.)
INSANITY,
recognition of by the ancients, 1
facts of, stated in certificate, 71-75, 365
» communicated by patient's friends, 75, 365
discharge of patients in consequence of insufficient facts of,
69-71, 392
in the reign of Elizabeth, 4
varieties of, 268 4
statistics of in various countries. (See Statistics or Insanity.)
INSPECTION OF ASYLUMS in Ireland, 193, 195, 198, 202
IRELAND,
lunacy in, 190-202
licence for asylums in, 190
order and statement, 190, 191
medical certificates, 192
notice sent to Inspectors, 193
form of entry left at asylums, 193
Inspectors of asylums, 193, 195, 198, 202
books kept at asylum, 194
notice sent by medical superintendent to registrar, 194
escape of patients, 194, 195
visitation of asylums in, 195
single patients in, 196
Commissions of Lunacy in, 196, 197
statistics of insanity in, 198
private asylums, list of, in, 199, 200
public ,, és 201, 202
INDEX 431
J
JURISDICTION OF COMMISSIONERS IN’ LUNACY,
places within, 30, 306
JURY,
when one may be demanded by alleged lunatic, 116
Commission, de lunatico inquirendo, without a, 117
power of Master to summon a, 122
jury to be had if lunatic is beyond jurisdiction, 120
examination of alleged lunatic by, 123
JUSTICES OF THE PHACE, ex-officio visitors of asylums, 30, 308
pauper lunatic ordered to be brought before, 95, 98
notice given to, that a lunatic is resident in parish, 97, 404
in the examination of the lunatic may be assisted by a medical
man, 98, 405 :
lunatic wandering at large to be brought before, 108, 412
licensed house beyond the jurisdiction of Commissioners
granted by, 30, 308
granting of licences by, 206
offence against Lunacy Act, person to be brought before, 343
form of conviction by, 344
who meant by, 350
order issued to bring pauper lunatic before the, 404
assisted by a medical man in examination of wandering lunatic,
413, 417
provisions respecting ill-treatment of wandering lunatic, orders
issued by, 414-417
K
KLEPTOMANIA, 278-280
L
LIABILITIES,
of proprietors and superintendents of asylums, 160-162
of person who signed order, 163-165
of medical men signing certificates, 165-169
LICENCES, bach .
for houses situated beyond the jurisdiction of Commissioners
granted by justices of the peace, 30, 308
of houses within the jurisdiction of the Commissioners, 34, 313
form of, 34, 353, 400
Commissioners’, remarks on, 34-38
duration of, 38, 313
432 INDEX
LICENCES (continued),
cost of, 38, 313
to include more than one house, 39, 361
refusal to renew, 40, 317, 318
not required for single patient, 33
in Scotland, 174
in Ireland, 193
in France, 204, 206
in Belgium, 215
in Germany, 223
penalty for infringing terms of, 389
LICENSED HOUSES FOR THE INSANE, how defined, 351
within the immediate jurisdiction of the Commissioners, 30, 306
visitation of by Commissioners, 32, 324, 393
enquiries made by the Commissioners at their visitation, 32, 326,
327
night visitation of, 32, 330
discharge of patients by Commissioners from, 33, 331, 329, 392
residence of medical officer in, 38, 39, 319
a licensee in, 361
admission book, kept in, 42, 819, 354
Case Book in, 42-44, 323
discharge of patients from, 44, 330, 398
death of patients in, 45, 321, 324
medical journal, kept in, 45, 366
books to be placed before the Commissioners, 45, 46, 319
entries in, official books, kept at, 31, 46, 327, 395
escape of patients from, 46, 320, 321, 335
trausfer of patients from, 47, 317, 368
boarders in, 48-51, 363, 390
correspondence of patients in, 51, 397
ill-treatment or neglect of patients in, 51, 364
unjust confinement of patients in, 52, 322
search for persous in, 52, 334
visits of friends to patients confined in, 52, 335
temporary leave of absence from, 53, 335, 396
attendants in, 53-55, 371
order for admission in, 56-59, 253, 254, 376
statement, 59-63, 320, 376, 380
medical certificates, 63-77, 362
list of metropolitan licensed houses, 77, 78
», provincial, 79-81
admission of pauper patients into, 100, 101
$7 Chancery patients into, 139
ae eae
INDEX. 433
LICENSED HOUSES FOR THE INSANE—(continued),
In Scotiann,
statement of admission into, 170
medical certificates, 171
order granted by Sheriff for admission into, 172
notice of admission, 173
report of, 173
resident medical officers in, 174
discharge of patients from, 175
register kept in, 176, 177
death of patient in, 178
' register of deaths, 178
boarders in asylums, 178, 179
correspondence of patients in, 181
list of, 186, 187
list of, rx Irevanp, 186
order and statement for admission, 190,194
medical certificates, 191, 192
notice of admission, 193
book of entry kept in, 193
escape, removal, or death of patient in, 194, 195
visitation of, 195
Inspectors of, 198
list of private licensed houses in, 199, 200
beyond the immediate jurisdiction of Commissioners, 31,
308
In France
admission of “ voluntary” patients in, 205,206
“Judicial” lunatics, 206
alleged lunatics confined in, 206
* private licensed houses in and near Paris, 213, 214
In Betcrum,
admission into, 215, 217
discharge of patients from, 217, 218
classification of lunatics in, 218
medical officers in, 218
In Germany, ‘
private licensed houses in and vicinity of Berlin, 237-242
(See also ASYLUMS.) a
LORD CHANCELLOR, :
' Masters in Lunacy and Commissioners appointed by, 28, 29, 300
‘ report of the Commissioners directed to, 29, 336
may recall or revoke licence, 40, 318
petition for Commission presented to, 114, 115,
FF
434 INDEX,
LORD CHANCELLOR—(continued),
¢
may order a jury, 116, 120
order for Commission signed by, 117
Commissioners’ report that the property of lunatics is not pro-
tected, made to, 119
Master certifies that a jury is desirable to, 122
Committee must reside within jurisdiction of, 125
money allowed for maintenance of lunatic’s family by, 128
permission for retirement of Committees granted by, 129
order issued after Commission by, 132
removal of Visitors by, 134
lunatics not within jurisdiction of the Court, appointment of
Committees by, 134, 135
order for supersedeas issued by, 136 :
traverse of inquisition conducted by, 137
form of traverse presented to, 138, 139
order for removal of single patient by, 339
Master in lunacy directed by, to inquire into cases of alleged
lunacy, 339, 340
power granted to employ persons to inquire into the condition
of asylums, 348
may authorise the discharge of a single patient, 367
LUNACY COMMISSION. (See Commission.)
LUNACY ACTS. -(See Acts.) 299—401
LUNACY COMMISSIONERS, changes in, 256, 257
LUNATICS
In Encranp—
meaning of the term, 349
treatment of, in the olden times, 4, 8, 11, 12 3
admission of, into private asylums, 41, 56—81
private, 56-81
pauper, 94-110
Chancery, 111-139
dangerous, 33, 331
discharge of, from asylums, 38, 44, 99, 101, 330, 398
death of, 45, 87, 180, 321, 368
illegal grounds for detaining, 41
transfer to other asylums, 47, 317, 368, 369
escape of, 46, 320, 321
letters written by, 51, 3897
ill treatment or neglect of, 51, 322, 364
unjust confinement of, 52, 322
visit of friends to, 52, 53, 334
leave of absence granted to, 53, 335, 396
INDEX. 435
LUNATICS—(continued),
admission into private BOs, 83, 85, 133. (See SrncLE
Patients.)
admission of paupers into county and borough asylums,
94, 97
admission into workhouses, 101
» 4, St. Luke's Hospital, 140-151
admission into Bethlehem, 152-159
protection of property by Commissioners, 33, 339, 370
wandering at large, 102-106, 412, 413
In Scorzann—
asylums in, 170-173
discharge from asylums, 175
death of, in asylums, 178
correspondence in, 181
private houses in, 179
In Ireranp—
admission into asylums, 190-193
discharge from asylums, 195
escape of from asylums, 194,195
private houses in, 196
In France—
“voluntary” patients in, 205, 208
“judicial” patients in, 206
dangerous patients in, 206
In Bererum—
admission into asylums, 215-217
discharge of patients, 217
classification of patients, 218
insane colony of Gheel, 224-229
(See also Cuancery Patients, Pavrer Lunatics, Private
Patients, and Since Parients.)
LUTWIDGE, Mr. R. W.S., late Commissioner, death of, 257
M
MAINTENANCE OF LUNATIC,
person who signed order responsible for the, 57
inquiry into same for, by Master in Lunacy, 124, 125
conducted by Committee of the Person, 126, 127
alteration, scheme for, 128, 130
maintenance of lunatic’s family, 128
(See also Cuancery Lunatics.)
FF 2
436 ENDEX.
MANAGEMENT OF ASYLUMS, on the, 41-55
MANTA, acute and chronic, 269, 270°
MASTERS IN LUNACY,
appointment by Lord Chancellor, 28, 300
names of, 28
salary of, 28
Commission conducted by, 120
jury summoned by, 122
enquiries made subsequent to Commission by, 124, 125
approval of Committees by, 125, 126, 129, 180
on death of lunatic, power to open documents given to, 130
to act as visitors, 133
directed by Lord Chancellor to inquire into alleged lunacy,
339, 340
expenses of, how paid, 341
(See also Cuancery Lunatics.)
MATRONS, provision for superannuation of, 387
MAUDSLEY, Dr., statistical table of, 22
MEDICAL ATTENDANT,
meaning of term, 350
residence of, in asylum, 38, 39, 319
not to sign a medical certificate, 64, 310:
on single patients, duties of, 83, 366
entries made by, in Medical Visitation Book, 85, 366
to send a report concerning single patients, 86, 367
MEDICAL CASE BOOK, 42, 323
MEDICAL CERTIFICATES FOR ADMISSION,
of private patients into asylums, 68, 320 ;
of single patients into unlicensed houses, 84-85, 336, 364
of pauper patients into county asylums, 94-98, 409
- fA », private licensed houses, 100
time allowed ioe amending the, 41, 66, 365, 392
copy of, sent to the Commissioners, 44, 320, 347, 892
omissions usually made in, 69
inspected by Commissioners at time of visit, 46, 327
persons prohibited from signing the, 64, 365, $91
remarks by Commissioners on, 64, 66
form of, 68, 377
mistakes invalidating the, 66
discharge in consequence of insufficient facts in, 69-71, 392
‘facts’ observed by the medical man in signing the, 71-75, 365
“tother facts’ communicated to the medical man, 75
instructions respecting signing, issued by the Commissioners,
76, 252-256
INDEX. 437
MEDICAL CERTIFICATES—(continwed),
of admission into St. Luke’s Hospital, 147, 148
” ” ” Bethlehem, 158, 159
action for receiving a patient without the, 161-163
liability for receiving a patient without the, 160, 362
liability of medical men signing the, 165
in Scotland, 171
in Ireland, 192
in France, 205-208
in Belgium, 216, 217
in Germany, 233
may be pleaded in bar of legal proceedings, 341, 342
if lost in post the person who sent them is not responsible, 347
** Special Circumstances” when one only is required, 62, 68, 862
false certificates, prosecution for, 366
MEDICAL JOURNAL,
to be kept at asylums, 45, 366
form of, 359
inspection by Commissioners of, 45, 366
entry made in, by medical man respecting a single patient, 85,
366
MEDICAL OFFICER,
must be duly registered under Ket 399
residence in asylum, 38, 39
MEDICAL EVIDENCE IN COURT, 297, 298
MEDICAL VISITATION BOOK, 31, 323, 336, 381, 398
for single patients, provisions respecting, 85, 86, 336, 398
false entry in, a misdemeanour, 86, 323
entry made in, by medical attendant, 85, 336
inspected by Commissioners, 85, 336
form of, 86, 381
MELANCHOLIA, 271, 274
MIDDLESEX, NEW ASYLUM FOR, 250
MITCHELL, Dr. A., Commissioner in Lunacy for Scotland, 181
MONRO, Mr. G. M., Commissioner in Lunacy for Scotland, 181
MONOMANIA, 270
MORAL INSANITY, Dr. Forbes Winslow on, 288-292
N
NAIRNE, Dr. ROBERT, Medical Commissioner in Lunacy, 29
NEGLECT OF PATIENTS, 51, 322, 364
of single patients, a misdemeanour, 364
438 INDEX.
NICHOLSON, Mr. WILLIAM NORRIS, legal Chancery visitor,
183 .
NIGHT VISITATION OF ASYLUMS,
by Commissioners, 32, 330
NOTICE
of application for licence, 34, 311
of patient’s admission sent to Commissioners, 44, 356, 370
form of, 370, 380
of discharge, 44, 87, 358
of lunatic wandering at large, 102, 103, 412, 413
-of death, 45, 87, 358
of patient’s escape and recapture, 46, 320, 321
of transfer, 47, 368
of engagement or discharge of attendants, 54, 371
to relieving officer by medical officer’ of parish, that a pauper
lunatic is resident in the parish, 94-97, 4038
to justice, 97, 404
of recovery of a pauper lunatic, to guardians, 101, 368
to alleged lunatic, on presentation of petition for Commission,
116 —
In Scornanp,—
of admission, 173
of discharge, 175
of death, 178, 179
In IreLanp,—
of application for licence, 190
of admission, 193
of discharge, removal, or death, 195
of escape, 194
-In Francs,—
of licence, 204
In Beteium,—
of licence, 215
of admission, 216
of discharge, 217
NUGENT, Dr. JOHN, Commissioner in Lunacy for Ireland, 198
NYMPHOMANIA, 278
0
OATH,
meaning of, 351
form of, taken by Commissioners in Lunacy, 303
taken by their clerk and secretary; 306
i OFFICIATING CLERGYMAN OF A PARISH,’ meaning of, 349
‘
INDEX. 439
ORDER
for admission of private patient, 56-59, 252, 254, 320, 362
amendment of, 365, 392
form of, for private patients, 376
form of, for pauper lunatics, 407
for single patients into unlicensed house, 83-85, 336, 364
persons prohibited from signing the, 56, 365, 391
liabilities of persons signing, 163, 362
only available for one month from date of signing, 58, 391
for admission into St. Luke’s Hospital, 145
$4 Bethlehem ditto, 156
for admission into county asylums, 95-97, 407
for Commission of lunacy, 117, 120
power of court to refuse such, 118
for delivering up lunatic’s documents, 131
issued after Commission, 132
for supersedeas, 136
In ScotranD,—
granted by sheriff, 172
In Ineranp,—
for admission, 190, 191.
P
PARISH,
meaning of, 349 :
PATIENTS. (See Lunatics—Sineiz Parrent—Parivate Patients.)
meaning of term in Act, 350
book of, 46
PAUPER PATIENTS, 94-110, 364
meaning of term in Act, 94, 350
proceedings prior to admission into county asylum of, 94
notice sent to relieving officer of parish, 94-97, 390, 403
section of Act especially referring to, 94-97
summary of chief sections relating to, 97-98
examined by minister of parish, 97, 407
ordered to be brought before a justice of the peace, 98, 390, 404
one medical certificate only required for, 98, 364
provision for sending to licensed houses, or workhouses, 98,
100, 390, 394
leave of absence of, 99, 335
discharge of by Visitors, 99, 332, 410
reception of by relatives at home, 99:
death of, 99, 321, 368
440 INDEX.
PAUPER PATIENTS—(continued),
discharge by guardians of parish from licensed house, 100, 330
$5 minister 9 or the justices from licensed
houses, 100, 411
notice of recovery sent, 100, 368
form of order for admission of, 378, 407
im statement of, 378, 406, 467
», medical certificate, 364, 379, 409
removal of single pauper lunatics to asylum, 394
PERCEVAL, Mr. CHARLES SPENCER, Secretary of Commis-
sioners, 29, 257
PHILLIPS, Mr. CHARLES PALMER, Legal Commissioner in
Lunacy, 29, 257
PHYSICIAN, meaning of term, 399
POST. The person is not responsible for documents if put in,
PRICHARD, Dr.,
on lucid interval, 270
on monomania, 271
PRIVATE PATIENTS, 56-81, 252
proceedings prior to admission into asylum, 41, 56
order for admission of, 56-59, 252, 254, 320, 362
form of, 376
statement, 59-63, 320, 362, 376
medical certificates for, 68-77, 320, are (See Mepicat Crrti-
FICATE)
list of metropolitan private asylums fox, 77, 78
» provincial + 79-81
transfer of, 47, 317, 368
discharge of from asylum, 44, 330, 398
death of, 45, 321, 358, 368
escape of from asylums, 46, 320, 321
visit of friends to, 52, 53, 334
person who signed order may authorise the discharge of, 57, 330
single private patients, 82-93
In Scottanp,—
admission into private asylums, 170-173
discharge of from asylums, 175
death in asylums, 178
correspondence of, 181
private single patients, 179
list of private asylums in, 186, 187
In IneLanp,—
list of asylums in, 199, 200
admission into asylums, 190-193
INDEX. 441
PRIVATE PATIENTS—(con tinued),
discharge from asylums, 195
escape of from asylums, 194, 195
private single patients, 196
In France, —
“ voluntary,” 205, 206
“judicial,” 206
asylums in Paris for, 218, 214
Tn Beterum,—
admission into asylums, 215-217
discharge of, 217
PROCTOR, Mr. B. W., Hon. Commissioner in Lunacy, 29
(See also Lunatics.)
PROPERTY,
protection by Commissioners of, 33, 119, 339, 370
dealing with, (See Cuancury Lunatics), 111-139
PROPRIETOR, :
application for licence by, 34, 307
liabilities incurred by, 160-163
of private houses for single patients, order addressed to, 83
may plead order and medical certificate in bar of legal proceed-
ings, 341, 342
how defined, 350
provision as to non-resident, 389
transmission of Commissioners’ entries by, 395
PROSECUTION,
for ill-treatment or neglect of patients, 51, 322, 364
for receiving a patient without medical certificate, 161, 162,
362
against person who signed order, 163, 165, 362
for illegality in signing medical certificates, 166, 167, 366
against an unregistered practitioner, 168, 169
PUERPERAL MANIA, 292
R
RAY, Dr., on Kieptomania, 280
RECOVERY,
of patients, 368
small probability of, 20
notice of, 44, 101, 358, 368
restoration of lunatic’s property in the event of, 113
RECURRENT MANIA, 269
442 INDEX.
REGISTER OF DERE REEe: DEATHS, ADMISSIONS, (See
Booxs oF. ,
In Scorranp,
of lunatics, 176
of deaths, 178
REGISTRAR OF DEATHS, notice to be sent to, 45
RELATIVES,
provision as to single patients, 90
order for admission signed by, 56
RELIEVING OFFICER,
notice sent to, that a lunatic is resident in the parish, 94-97,
403
notice sent to justices by, 97, 404
roust send lunatic to asylum, 98
RESTRAINT,
‘to be entered in the medical journal, 45
” ” 35 visitation book, 86, 823
inquiry by Commissioners as to the amount of, 32, 347
REVOCATION OF LICENCE,
at request of Commissioners in Lunacy by Lord Chancellor, 40,
-318
notice to be given of the, 40, 318
ROBERTSON, Dr. LOCKHART, medical Chancery visitor, 133
RUSH, Dr., on Kleptomania, 279
RUSSIA, lunacy in, 247
S
8f. LUKE'S HOSPITAL, particulars relative to reception of
patients in, 140-151
SALARY
of Commissioners in Lunacy, 29, a
of secretary, 30, 304
of Masters in lunacy, 28
of Visitors in lunacy, 133
SCOTLAND,
lunacy in, 170-189
statement previous to admission into asylum, 17 o
medical certificates, 171
order for admission issued by Sheriff, 172 s
notice of admission, 173
medical report, 173 !
false medical certificates, 174
licence for private houses, 174
resident medical officer, 174
discharge of patients, 175
INDEX. 443
SCOTLAND—(continued),
power of Board to discharge a patient, 175
notice of discharge to Sheriff, 175
removal of a patient, 176
register of lunatics in, 176
death of patients, 178
‘register of deaths, 178
boarders in asylum, 178
single patients, 179-180
correspondence of patient, 181
Commissioners of lunacy in, 181, 182
statistics of insanity in, 182-187
private asylums in, 186, 187
public asylums in, 188, 189
SECLUSION,
remarks by Commissioners on, 260
SECRETARY OF COMMISSIONERS, 29
not to be interested in any house, 310
oath taken by, 305
SHAFTESBURY, LORD
Lunacy Act, 1845, introduced by, 16
chairman of the board, 29
remarks on single patients by, 92, 93
SINGLE PATIENTS, 32, 82-93, 336-388, 364
statistical table of, 82
proceedings prior to admission of, 83 \
order, statement, and medical certificates, 83-85, 336, 364
visitation of, by Commissioners, 84, 338, 371
visitation of, by Visitors, 366
no licence required for, 84, 319
instructions issued by the Commissioners respecting, 84-87
discharge or death of, 87, 367, 369, 398
medical visitation-book for, 85, 86, 336, 398
transfer of, 86, 368
change of residence of, 86, 369, 370
removal of, for health, 86, 369
annual report by medical attendant of, 85, 367
medical attendant of, 83, 85, 366
visitation less frequently than once a fortnight, 366
illegal detention of, and prosecution by Commissioners, 88, 89
statutory provisions respecting and opinion of counsel on, 89-92
remarks by Lord Shaftesbury on, 92, 98
Chancery single patients, 133 —
in Scotland, 179, 180
444 INDEX.
SINGLE PATIENTS—(continued),
in Ireland, 196
remark by Commissioners in Lunacy on, 261-264
discharge of, by Lord Chancellor, 267
STATE LUNATICS,
visitation of, 348
STATEMENT,
of bodily health and condition of patient, 44, 254, 356
of single patient, 88, 84, 336, 364
of facts previous to the admission of a patient, 59. “63, 320, 392°
form of, 376, 380
to be sent to Commissioners, 392
for removal of pauper patients to asylums, 394
STATISTICS OF INSANITY,
in England, 19-27
recent, 249
in Scotland, 182-187
in Ireland, 198
in Franee, 208-210
in Belgium, 229-232
in Germany, 242
in America, 243
in other countries, 266, 267
SUMMONS,
by the Commissioners, form of, 360
SUPERINTENDENT OF ASYLUM,
residence of, 38, 39, 361
- duties on admission of a patient, 41, 319
liabilities of, 160-163
order and medical certificate may be ‘pleaded i in bar of legal pro-
~ceedings, 341, 342
SUPERSEDEAS OF INQUISITION, 136
form of, 136, 137
SURGEON,
meaning of term as‘ used in Act, 399
T
TAYLOR, Dr. A. S., on dementia, 274
TRANSFER,
of patients to another asylum after expiration of licence, 47,
317
from one asylum to another, 47, 317, 368
form of consent and order for, 48 j
INDEX. 445
TRANSFER—(continued),
preliminaries previous to, 47, 48
notice to be given to the Commissioners of, 47
TRAVERSE,
of inquisition, 137, 138
form of, 138
U
UNLICENSED HOUSES,
(See Sincie Patients), 82-93
UNSOUND MIND,
‘ varieties of, 268
Vv
VISITATION
by Commissioners of licensed houses, 31, 32, 324, 393
inquiries made at, 32, 347
entries in official books at time of,’46, 395
of single patients in unlicensed houses, 84, 338, 371
of Chancery patients in licensed houses by Chancery visitors,
183
of Chaucery patients in unlicensed houses, 84
by Visitors of houses not within immediate jurisdiction, 31,
325, 326
entries made at time of, 31, 325
of gaols and workhouses, 33, 101, 347
of County and Borough Hospitals, 347, 393
of lunatics under charge of Committee, State and criminal
lunatics, provision respecting the, 348
VISITORS
of Chancery patients, 133
names of, 133
limited power of, 134
only to hold office during good behaviour, 134
of houses not within jurisdiction of Commissioner, 31, 325, 326
oath taken by, 31, 308
discharge of pauper lunatics by, 99, 832, 410
copy of official entries sent to, 395
order for removal of pauper patient to asylum by, 418
VISITORS’ BOOK, 31, 46
ViSITS,
of friends to patients, 62, 53, 334
of Commissioners and Visitors, (Se Visitation), 31, 325, 393
446 INDEX.
WwW ;
WANDERING LUNATICS.
provisions relative to, 102-106, 412
WAUCHOPE, Sir JOHN DA, Chairman of Commissioners in
Scotland, 181
WARREN, Mr. SAMUEL, Master in Lunacy, 28
WILKES, Mr. JAMES M., Medical Commissioner, in Lunacy, 29
WILL, deposited in Master's office, power to open it, 180, 131
WINSLOW, Dr. FORBES, on delusion, 281
rf a on dipsomania, 285
$i ‘i on moral insanity, 288-292
WITNESS,
subpena in case of Commission, 120
summoned by Commissioners, 342
WORKHOUSES,
power to receive patient in asylum from, 394
number of patients on Jan, 1, 1872, 101
dangerous lunatics in, 101, 390
section of Act referring to, 102
lunatics may be taken to, 98, 390
letter from Local Government Board respecting, 264, 265
visitation by Commissioners, 369
Y
YOUNG, Rt. Hon, George, Commissioner of Lunacy in Scotland,
181
LONDON: PRINTED BY
SPOTTISWOODE AND CO. NUW-STREET SQUARE
AND PARLIAMENT BTREMT
SMITH, ELDER & CO’S
MEDICAL PUBLICATIONS.
—o9300—
LECTURES on BRIGHT’S DISEASE ; with Especial Reference to
Pathology, Diagnosis, and Treatment. By Grorct JouNnson, M.D., F.R.S.,
Fellow of the Royal College of Physicians, Honorary Fellow of King’s
College, London, Professor of Medicine in King’s College, and Physician to
King’s College Hospital, Crown 8vo. 6s
On the CONVOLUTIONS of the HUMAN BRAIN. By Dr, Auexanper
EckER, Professor of Anatomy and Comparative Anatomy in the University
of Freiburg, Baden. Translated, by permission of the Author, by JoHN
C. Gatton, M.A. Oxon, M.R.C.S., F.L.S., Clinical Assistant in the West
Riding Asylum, late Lecturer on Comparative Anatomy at Charing Cross
Hospital. Post 8vo. 4s. 6d.
A TREATISE on the PNEUMATIC ASPIRATION of MORBID FLUIDS:
a Medico-Chirurgical Method of Diagnosis and Treatment of Cysts and
Abscesses of the Liver, Strangulated Hernia, Retention of Urine, Pericarditis,
Pleurisy, Hydarthrosis, &c. By Dr.Gzorexs DimuLaroy. Post 8vo. 12s. 6d.
A PRACTICAL TREATISE on URINARY and RENAL DISEASES,
including URINARY DEPOSITS. Illustrated by numerous Cases and
Engravings. By WrL1AM Roperts, M.D, Second Edition. Revised and
considerably Enlarged. Small 8vo. 12s. 6d,
A PRACTICAL TREATISE on the DISEASES .of the HEART and
GREAT VESSELS; including the Principles of their Physical Diagnosis.
By WALTER HayLe WaLsnE, M.D, Fourth Edition, thoroughly Revised and
greatly Enlarged. Demy 8vo. 16s.
A PRACTIGAL TREATISE on DISEASES of thé LUNGS: including
the Principles of Physical Diagnosis and Notes on Climate. By WALTER
HAYLE WALSHE, M.D. Fourth Edition, Revised and much Enlarged.
Demy 8vo. 16s. ;
| DEMONSTRATIONS of ANATOMY: being.a Guide to the Knowledge
of the Human Body by Dissection. By Guorem Vinur ELLs. Sixth
Edition. With 146 Engravings on Wood. Small 8vo. 12s. 6d.
An INTRODUCTION to the STUDY of CLINICAL MEDICINE: being
Guide to the Investigation of Disease, for the use of Students. By
Ooravivs Sruraes, M.D. (Cantab.), F.R.C.P. Crown 8vo. 4s, 6d.
- AUSCULTATION and PERCUSSION ; together with the other Methods
of Physical Examination of the Chest, By SAMUEL GzE, M.D. With Illus-
trations. Fecp. 8vo. 5s. 6d.
SYPHILIS and LOCAL CONTAGIOUS DISORDERS. By Berxeruy
Hu, M.B. Lond., F.R.C.S. Demy 8v0. 16s. :
2 Smith, Elder & Co’s Medical Publications.
THE ESSENTIALS of BANDAGING ; including the Management of
' Fractures and Dislocations, with Directions for using other Surgical Appa-
ratus. With 122 Engravings. By BERKELEY HILL, M.B. Lond., F,R.C.S.
Second Idition, Revised and Enlarged. Fep. 8vo. 3s. 6d. 3
A SYSTEM of SURGERY ; PATHOLOGICAL, DIAGNOSTIC, THERA-
PEUTIC, and OPERATIVE. By SamMvet D, Gross, M.D., LL.D., D.C.L.
Oxon, Fifth Edition, greatly Enlarged and thoroughly Revised, with
upwards of 1,400 Illustrations, 2 vols, 8vo. 37. 10s.
On the CONNECTION of BRIGHT’S DISEASE with CHANGES in the
VASCULAR SYSTEM: with Illustrations from the Sphygmograph. By-
A. L, Gaasin, M.A., M.D., Fellow of Trinity College, Cambridge. Demy
8vo. 1s. 6d.
A TREATISE on HUMAN PHYSIOLOGY ; designed for the use of
Students and Practitioners of Medicine. by JOHN C. DaLTon, M.D., Pro-
fessor of Physiology and Hygiene in the College of Physicians and Surgeons,
New York, &c. Fifth Edition, Revised and Enlarged, with 284 Illustrations,
8v0, 288.
A PRACTICAL TREATISE on FRACTURES and DISLOCATIONS.
By Frank Hastines Hamitton, A.M., M.D., LL.D., Professor of the
Practice of Surgery, with Operations,in Bellevue Hospital Medical College,
New York, &c. Fourth Edition, Revised and Improved. With 322 Illus-
trations. 8vo. 28s.
SURGICAL DISEASES of INFANTS and CHILDREN. By M. P.
GUERSANT, Honorary Surgeon to the Hépital des Enfants Malades, Paris, &c.
Translated from the French by R. J. DuNGLISON, M.D. 8vo, 12s.
ESSENTIALS of the PRINCIPLES and PRACTICE of MEDICINE.
A Handbook for Students and Practitioners. By Hmnry HARTSHORNE, A.M.,
M.D., Professor of Hygiene in the University of Pennsylvania. Third
Edition, thoroughly revised. Post 8vo.12s. ~
A GUIDE to URINARY ANALYSIS, for the use of Physicians and
Students. By H. G. Pirrarp, A.M., M.D., Physician to the Charity Hos-
pital, New York, &c. Demy 8vo. 7s. 6d.
QUAIN and WILSON’S ANATOMICAL PLATES. 201 Plates. 2 vols.
Royal folio. half-bound in morocco, or 5 Parts bound in cloth, £10. 10s.
coloured ; £6, 6s. plain. -
MEDICAL DIAGNOSIS, with SPECIAL REFERENCE to PRACTICAL
MEDICINE. A Guide to the Knowledge and Discrimination of Discases.
By J. M. Da Cosra, M.D., Lecturer on Clinical Medicine and Physician to
the Pennsylvania Hospital, &c. With Illustrations. Third Edition. 8vo. 24s.
GENERAL and DIFFERENTIAL DIAGNOSIS of OVARIAN TUMOURS,
with Special Reference to the Operation of Ovariotomy, and Occasional
Pathological and ‘Cherapeutical Considerations. By WASHINGTON L. ATLEE,
M.D. With'39 Illustrations. 8vo. 20s,
INJURIES of NERVES and their CONSEQUENCES. By S. Wer
MrrcuELL, M.D., Fellow of the Philadelphia College of Physicians, Physician
to the Philadelphia Orthopedic Hospital and Infirmary for Diseases of tte
Nervous System, &c. 8vo. 15s,
SMITH, ELDER & CO., 15 Waterloo Place.