Upon a former occasion, we adverted to some of these; and at: present shall confine ourselves to a few of the remarks made by Mr Parkinson, who seems to have considered the subject very attentively.

"One of the most important regulations in this act, is that which is intended to prevent keepers of mad-houses from receiving patients without having an order, in writing, under the hand and seal of some physician, surgeon, or apothecary. But it appears doubtful, whether this clause, as at present worded, yields that security which was expected from it, owing to its admitting the validity of an order, signed by any person, whose claim to be considered a member of the medical profession rests only on his designating himself an apothecary. Such persons are not legally recognised as fit judges of the maladies to which the human system is subject. Their abilities have been examined by no prescribed test, nor have they received any authority to take on themselves the delicate and important task of judging of, of of practising upon, the diseases either of the body or of the mind.

"That in this metropolis, and in many parts of the empire, there are many very respectable persons, who, with the designation only of apothecaries, possess every acquirement which is requisite for the successful exercise of their profession, is well known. But it is equally well known, that there is hardly a neighbourhood which is not infested with some ignorant and illiterate being, who having learned the names of many medicines, and of some diseases, seeks a livelihood by putting the lives of his neighbours at hazard, by pretending to remove the diseases with which they may happen to be afflicted.

"Should the range of such men be enlarged?-Should they, in ad dition to the calamities with which they are now able to inflict the families around them, be empowered, at their will, and on their judg ment, to decree the confinement in a mad-house, of any one, whom, from their ignorance, their pliant servility to a superior, or their easy yieldings to interested and well-managed importunities, they may be induced to term insane? A decided negative to these questions must surely be given, after considering the possible, nay, the proba ble consequences of such a permission..

"In places somewhat distant from the metropolis, characters of such a description are most likely to be found; and there are they enabled to occasion the greatest injury. For, supposing that any person of this description should improperly, but according to the best of his judgment, and under circumstances artfully contrived to secure his compliance, grant a certificate of lunacy, the subject of that certificate may directly be consigned to a mad-house; and if the house to which he is thus consigned should not be within seven miles of the metropolis, or within the county of Middlesex, the keeper of such house is not required to give notice of the receipt of such person, but within fourteen days. For a period of this length, therefore, a person manifesting only an eccentricity of manner, perhaps even the consequence of a superior degree of intellect, may, from caprice, interested motives, or ill-judged temerity, be condemned to the horrors of a

mad-house, without an opportunity, being cut off from all communication with society, of claiming his release; and without a chance of any of his relations or friends obtaining înformation of the place of his concealment.

But what takes place even at the expiration of the fortnight?— The keeper of the house sends notice of having received a patient of such a name into his house, and what then?—if no friend or relation should think of making inquiry respecting him, he may wait for his release until the visitation of the house by the commissioners appointed for this purpose. This may not happen quite so early as the unfortunate prisoner may wish, since the act only requires a visitation from the commissioners within seven miles of London and Westmin ster, and within the county of Middlesex, once at least in every year; and at a distance of more than seven miles, and out of the county of Middlesex, only as often as they shall think fit; no certainty of a visitation within any given period being here assured.

But let the difficulty of determining in many of these cases be attended to, and then let the propriety of trusting to persons of this description for a decision, in such cases, be considered. ”

Upon this subject we perfectly agree with Mr Parkinson; and, willing, as we are, to permit every man to intrust his health to whom he pleases, we have always considered that the law has never made a sufficient distinction in regard to their testimony, professional charges, and in matters of certificate, between regular and irregular practitioners.

We have also selected the following paragraphs as worthy of consideration, by calling the attention of practitioners and legislators to difficulties connected with the present act, and pointing out what the author conceives to be the best means of removing

them.

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"Patients are frequently brought from a considerable distance in the country, to some mad-house in town, and without a regular order. The patient may be a decided lunatic, in a paroxysm of dreadful exertions; but as he is not accompanied by a regular order, the keeper of the house cannot receive him, until a medical person can be found to certify his lunacy. In this interval, he must remain exposed to an accumulating crowd, unless, which is not always the case, some other place can be found near the spot, in which he can be received for that of time. Other patients, those who are disposed on any little space temporary irritation to dangerous acts of violence, may be also brought, without a certificate, from a distance, immediately after a dangerous paroxysm, but now in an interval so lucid, as not to enable a stranger to determine, from an examination, at that time, whether he is a lunatic or not. If admitted, the penalty is incurred, and if not, serious and even fatal mischief may be the consequence. Might not, in the first of these cases, when the madness is evident, the patient be received, and twelve hours be allowed for shelter, before the order shall be required to be signed? Where the patient is said to be dangerous, but the disease is only apparent, might not his continuance under con

finement be allowed for twenty-four hours, to allow of further examination, and an opinion of higher authority, before signing the order? "But assuming that a patient is regularly received into a house of this description, what means of assurance does the act offer, that he shall obtain his liberty as soon as his recovery shall be completed, and that he shall not be detained from any improper motives of his relatives, or of his keeper? The only answer that can be here offered, is, that the act obliges the visitation of the commissioners, once at least in every year, and at times of which no notice is given to the keepers of these houses. But cases frequently occur, in which the necessity of confinement exists but for a few days.

"It appears, therefore, to be necessary, that some provision should be adopted to prevent the unnecessarily long detention of a patient in these houses; but it is equally necessary, that the keepers of these houses, the relations, and even the medical attendant, should be protected in those cases; in which, from the ambiguity of the case, the necessity of the continuance of confinement is not evident to those who are not in the situation of frequently seeing the patient.

-a re

"An obvious mode of proceeding here indeed presents itself;ference may be made to a physician, on whose opinion the decision may be made; but who is to nominate this physician? By whichever party he is nominated, the other may find objection to the appointment; and if another should be called in, and a difference of opinion should. arise, what is then to be done? It may be said that a commission of Lunacy may be obtained; but, independent of the expense of such a proceeding, the case is assumed to be of such a kind, as to render this mode improper, since the patient is supposed to be either convalescing or cured. In such cases, should not the opinion of one of the commissioners under this act be rendered attainable, on payment of a certain sum, &c. and without previous application to any of the courts of law? the opinion thus obtained being efficient for the protection of the relation, as to that particular act; or for the liberation of the patient, unless notice within a certain time is given, of claiming the o pinion of the whole board, or of bringing the case before a jury.

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"Should circumstances arise, which shall procure a revision of this act, it is to be hoped that a clause will be introduced to prevent er punish any cruelty or misdemeanor towards any insane patient. "

We cannot omit this opportunity of again stating, that Scotland has hitherto been left without any regulations in regard to lunatics. There is no legal provision for criminal or pauper lunatics. Some of the latter are daily to be seen infesting the streets even of the capital; and our common jails enclose for life several of the former description. As to private mad-houses, it is sufficient to observe, that every person, however ignorant, or unprincipled, may keep a prison under that title; and that, unless where some person having a legal right, procures a warrant to search for an individual suspected to be confined in one of them, they are under no controul whatever, and the conduct of their keepers is never inquired into.

PART III.

MEDICAL INTELLIGENCE.

Report of Diseases treated at the PUBLIC DISPENSARY, (near Carey-Street), London, from Feb. 28th to May 31st, 1811.

The spring has been favourable to vegetation, which advanced earlier than for several years back. This probably arose from an unusually clear state of the atmosphere, which admitted of a constant direct influence of the sun, during the whole of the month of March, followed by a mild temperature during the greater part of April and May, with occasional heats, lasting for two or three days. The wind was from the east, however, during March, and frequently in the following months; whence the evening and night air was generally chill, especially in March, and was the more felt from the contrast with the morning sunshine, especially by those whom the latter had induced to discard their winter garments. March was uniformly dry; some mild rains occurred in April; and May has been rather showery throughout, with several smart thunder storms.

The frequent vicissitudes, and the general chillness of the evenings, may be sufficient to account for the continuance of catarrhal affections, many of which were of considerable severity, during a spring which has been, on the whole, mild. They continued to preserve the same character, which had marked the catarrhs of the winter; namely, to exhibit a greater degree of feverishness and depression of strength, than was proportionate to the state of bronchial inflammation: but we have not observed any other approximation to the character of influenza.

The instances of mild continued fever have been rather numerous; but, as usual, presenting themselves under a variety of forms, never assuming a typhoid appearance, nor spreading from individual to individual, and generally not lasting above ten or eleven days, and terminating well. In a word, these fevers have