medical officer the duties of classifying the female patients, of deciding which of them should be employed, and of regulating the employment, and of determining in which wards they should be placed; and had invested the matron with this power. He had, in fact, unwarrantably and most injudiciously assigned to her the whole moral treatment of the female patients; and all this mischief he had done of his own motion without reporting such interference to the Governors. The hiring and discharge of attendants and servants were also in his hands. The evil consequences of a state of things in which the medical officer had all the responsibility, and no power, while the treasurer assumed all the power and no responsibility, may easily be imagined. There was no unity in the management of the hospital, and the patients were grossly neglected and cruelly treated; female patients in the basement of the building were found to have regularly slept entirely naked on loose straw, with only a blanket over them, the poor creatures crawling under the straw in order to try to get warm; and the Commissioners intimate their belief, notwithstanding official denial, female patients were actually laid naked on the stone floor and mopped with cold water. The backs of the patients were excoriated through lying in wet and dirty straw; and one wonders not, after reading the evidence elicited, that health was sometimes materially injured, and life put in peril.

It would not serve any good purpose to go at length through the evidence taken by the Commissioners, in which facts denied by one witness are admitted and undisputed by another, and statements repudiated at one time by the same witness are acknowledged at another; but it is impossible to restrain surprise and disgust at the singular defence of such neglect and cruelty which Dr. E. T. Monro, who for thirty-five years had been the principal medical officer, and who was the son of him whose reputation suffered so much by the disclosures of 1815, does not shrink from making for himself. "The modern idea appears to incline to that hard working attention to minute particulars which has never hitherto characterized the mental physician exercising a high profession in a liberal manner; and if the duties of the future medical officer are to be so minute, and so extensive, and so laborious, he must, indeed, be of a very different grade and calibre from all physicians who have heretofore exercised this high calling." It is heartily to be hoped that future mental physicians will be of a very different grade and calibre, and we are convinced that there is nothing by which not the insane only, but the medical profes

sion, will gain so much as by the revolution which Dr. Monro dreaded. This gentleman being closely questioned as to whether a letter, complaining of the ill-treatment to which a patient had been subjected, had not been read at a meeting of the Committee of the Hospital where he was present, replied, "If I were to speak the truth from my heart, I believe not." Being then pressed as to the particular day on which it was actually read, he said, "I beg your pardon; I will recall what I just said." Then, after a little consideration, he added, "I am taxing my memory to the utmost, and upon second thoughts I do remember that the letter was read." It was furthermore elicited by the inquiry that it was the regular practice to discharge a patient whenever, through the progress of disease or through the effects of neglect and ill treatment, the health had been so reduced as that death might be apprehended. "All patients," said Dr. Monro, "who are so sick as to require the attendance of nurses are inadmissible; and when they become sick we send them to their relatives. They are discharged as being sick and weak. We do not pretend to provide for any but for the casual sick, and they are never admitted sick and never kept long if they are."

Meanwhile, though Bethlehem Hospital was the scene of such cruelties, and though mechanical restraint had been in systematic use there up to within eighteen months of the date of the Commissioners' inquiry, the great modern reform in the treatment of the insane had for some time been accomplished, and the principles of kindness and of moral control had superseded terrorism and mechanical restraint in all other asylums. It was in September, 1839, that Dr. Conolly presented his first report, as resident physician, to the magistrate of the Hanwell Asylum; and it was in that report that the abolition of mechanical restraint in that large asylum was announced. Dr. Conolly had entered on his duties as physician on the 1st of June, 1839, and on the 21st of September there was not a single patient in restraint. "No form of strait-waistcoat, no hand-straps, no leg-locks, nor any contrivance confining the trunk or limbs, or any of the muscles, is now in use," he writes in his first report. Even at so early a period he was able to say "that, notwithstanding some peculiar difficulties, the noise and disorder prevalent in some of the wards have already undergone diminution; that instances of frantic behavior and ferocity are becoming less frequent; that the paroxysms of mania to which many of the patients are subject are passed over with less outrage and difficulty; and that, if cases are yet seen which appear for a

length of time to baffle all tranquilizing treatment, they chiefly, if not exclusively, occur in acute mania, the symptoms of which would be exasperated by severe coercion, or among those who, having been insane many years, have been repeatedly subjected to every variety of violent restraint."* The experiment had previously been made on a small scale at the Lincoln Asylum by the united efforts of Dr. Charlesworth and Mr Hill, and made successfully. Indeed, it was from witnessing what had been done there that Dr. Conolly was convinced of the practicability of abolishing all form of mechanical restraint, and determined to carry out the non-restraint system on the large scale which his opportunities at Hanwell afforded. "The example of the Lincoln Asylum, in which no patient has been put in restraint for nearly three years, came also powerfully in aid of an attempt to govern the asylum at Hanwell by mental restraint rather than by physical." Once the hu mane system of treatment had been proved successful in an establishment containing at that time nearly one thousand patients, embracing every form both of acute and chronic insanity, it was certain that it must be applicable to every case of insanity, and to every asylum containing insane patients. Accordingly in the face of much prejudice and many obstacles, all forms of bodily restraints for the insane were dispensed with; and after an experience of three years at the Hanwell Asylum, it was established beyond all dispute that the management of a large asylum is not only prac. ticable without the application of bodily coercion to the patients, but that, after the total disuse of such a method of control, the whole character of an asylum undergoes a gradual and beneficial change." Every succeeding year afforded new and stronger proof of the great benefit of the entire disuse of mechanical restraint; asylum after asylum throughout the country made cautious trial of the new system, ending with its entire adoption, and much praise of its efficacy; and at last that which had been sneered at and rejected as the benevolent dream of enthusiasm was accepted generally as an article of faith not to be questioned. As ever happens in the case of any great practical reform, the non-restraint system was at first declared absurd and impracticable, then grudgingly accepted as worthy of trial under certain circumstances, and finally assimilated into the public habit of thought as a movement not new, nor one for which any individual could justly claim special credit.

* The reports of John Conolly, M. D., the Resident Physician of the County Lunatic Asylum at Hanwell, to the Michaelmas Session, 1842.

How little the inherent justice of the reform would have availed, but for the individual conviction and individual energy by which, through good report and through evil report, its triumph was secured, may easily be perceived by any one who will reflect on the condition of Bethlehem Hospital in 1851, as disclosed by the inquiry of Commissioners in Lunacy, and contrast it with the condition of Hanwell Asylum ten years earlier. Faithful to its traditions, that hospital clung to an evil system as long as this had any. lingering vitality, and abandoned it with regret when its utter decay rendered it a public nuisance, calling for public interference. The way in which the governors of Bethlehem received the recommendations of the Commissioners proves plain enough how blind they were to what the welfare of the insane demanded; and it is truly disheartening to read the observations which they thought proper to make in reply to the severe condemnation passed upon the mismanagement of the hospital. The Commissioners had felt it their duty to reflect upon the treasurer's conduct, to which undoubtedly they thought much of the evil in the state of the hospital was due; and the reply of the governors, signed by this very treasurer, is, that the course adopted by him had been proper and judicious. They are of the opinion also that the use of straw covered with a blanket is not unsuitable for the bedding of patients. insensible to the calls of nature, and indeed enter into various reasons to show how admirable and indispensable in such cases such bedding is. They could not venture formally to approve the practice of putting patients on straw, stark-naked, or, as they more euphoniously put it, without a proper supply of night-gowns; but they do not fail to display a lingering love of that practice, and positively to make a sort of defence of it in respect of suicidal patients. To one of their physicians, from whom nothing damaging had been elicited by the Commissioners, they feel it due to express their opinion that "all his proceedings in connection with the hospital have been characterized by industry and kindness;" while they are sorry that the other physician, who had made damaging admissions in his evidence, had not entertained correct views of his duties, "proving the propriety of those changes in the medical staff that have been recently made."

Of the three hundred governors of the hospital at that time, not more than half a dozen probably were really responsible for its unsatisfactory condition, or for the unsatisfactory defence unwisely put forward. Most of them were content to give their support to an excellent charity, and to leave the administration

of it entirely to those who, from whatever motives, showed greater interest in it, and gave greater attention to it. This is a fact in the history of many charities, which has been productive of much mischief; and assuredly it would sometimes be much better that a man should cease to be a governor if he ceases to give any thought to the government, than to allow the weight of his name- and character to be used by a few self-seeking men to prop up a system of gross mismanagement. The governors of Bethlehem in their defence lay stress on the fact that "they assiduously and gratuitously devote a large portion of their time to superintendence of the charity, and being above the suspicion of having any interested motive, or that they can possibly have any other object than for the perfect good of the institution," they feel it right to express their conviction "that if a mode of investigation, similar to that adopted by the Commissioners in their case, were to become general, it would discourage the supporters of numerous public charities, and would deeply injure many of those great institutions of benevolence which are universally regarded as the brightest ornaments of the land." Now what is the real value of such a statement in such a case? It was true, without doubt, as regards the governors generally; but viewed in relation to the actual circumstances, it was simply a complaint on the part of the person principally reflected upon, the treasurer, that unless he were allowed to go on managing affairs as hitherto, and, by such management, inflicting unspeakable suffering upon many unfortunate patients, he would be discouraged. It was surely far less likely that the Commissioners in Lunacy should have interested motives than an officer who, in addition to the power and influence attaching to his office, was provided with a furnished residence at Bridewell Hospital for his services to the charity. There is, unhappily, too much reason to think that many of our large public charities, which, like Bethlehem Hospital, have magnificent endowments, are grossly mismanaged, and, instead of being "the brightest ornaments of the land," they have been so warped from the noble purposes of their founders, as to make right-minded persons grieve heartily. Is it not too true that some of them, falling infinitely short of their just aim, have become vast accumulations of wealth, on which multitudes of parasites cling and live?

To an unprejudiced looker-on, it must have seemed strange that the governors should give so many excellent reasons in favor of a system, in order that they might forthwith abolish it, and so many excellent reasons against the recommendations of the Commis