Reviews and Notices of Books
1
187 Reviews and Notices of Books. Reviews and Notices of Books. Unsoundness of Mind in Relation to Crimiatal Acts. An Essay, to which the First Sugden Prize was this year awarded by the King and Queen’s College of Physicians in Ireland. By JOHN CHARLES BUCKNILL, M.D. Lond., Phy- sician to the Devon County Lunatic Asylum, pp. 148. London: Highley. 1854. IN these teeming days of authorship, when treatises appear on a single symptom of disease, and the copious flow of words ’forms so remarkable a feature in the literature of medical science, the perusal of a little book written in a terse, vigorous, logical style, is absolutely refreshing. Of Dr. Bucknill’s essay, we may say that its principal fault is the very unusual one of being too short. Yet we are not aware of any points of interest or importance which he has omitted, or which he has failed to illustrate with originality of thought and with the authority of experience. In the earlier pages, the author proves the fallacy of the current legal definitions of insanity, and that all metaphysical I definitions must, of necessity, be unsound and insufficient. He then seeks to establish his own view of unsoundness of mind, the peculiarity of which consists in the prominence he gives to the " element of disease." Society does, indeed, re- cognise insanity to be a disease of the body, or the care of those suffering from it would still be intrusted to spiritual guides. "Medical men experienced in the phenomena of insanity are not examined in courts of justice, because they may, to some extent, be mental philosophers, and acquainted with the origin of crime, the laws of responsibility, and such matters; but because they are physicians, and supposed to be capable of detecting the existence of disease." So far as we know, Dr. Bucknill is the first writer on this subject who has insisted on the paramount importance of re- garding criminal lunacy as a manifestation of diseased brain. Phrenological writers have made it dependent upon irregular cerebral function; but they disregarded the " element of dis- ease," and on this they fell short of the truth. Their doctrines would extend irresponsibility to all men for their acts; where- as, it is only for actions which are the result of disease for which this can justly be claimed. As to the mental tests of insanity, Dr. Bucknill distinctly states that none of them are trustworthy. He savs- judges, to meet cases where responsibility is diminished by partial disease; and that in these trials the judges should be assisted by medical experts, as in the Admiralty courts, the judges are aided by the Trinity masters, acting as amici curiœ. Dr. Bucknill urges the establishment of a state asylum in this country. In this respect we are behind Ireland, where they have an excellent institution of this kind at Dundrum. "In England, men who escape the punishment of heinous offences on the plea of insanity, are, for the most part, con- signed to the criminal ward at Bethlem; a place which has been justly referred to as a receptacle of insane criminals. " It is not a modern prison, for there is no corrective disci- pline ; it is not an hospital, for suitable treatment is impos- sible ; it is not an asylum for the relief and protection of the unfortunate, for it is one of the most gloomy abodes to be found in the metropolis. It is simply a receptacle, into which the waifs of criminal law are swept, out of sight and out of mind." Good sense and liberality of opinion, guided by practical experience, pervade the book, and we strongly recommend its perusal both to medical men and to lawyers. ADMINISTRATION OF CHLOROFORM. To the Editor of THE LANCET. SIR,—The particulars of several of the fatal cases of chloro- form bear out the statement of Mr. Syme as to the imperfect manner in which it is frequently administered. It is poured on a piece of lint, and the vapour inhaled in a volume : the lint being comparatively impervious to air, does not allow of its being sufficiently diluted, and the patient’s inhaling a sufficient amount of the surrounding air depends on chance or accident. Considering the powerful poisonous effect of undiluted, or insufficiently diluted chloroform vapour, as shown by various experiments on animals, the marvel is that deaths have not been more numerous; but we may hope that the attention now drawn to the subject will lead to the more careful admi- nistration of so potent an agent. To guard against such dangers, I have generally used an open sponge, of a triangular shape, about three inches long and two inches wide at the lower part. A piece of lint, or a handker- chief folded up lengthwise, about an inch and-a-half wide, is wrapped round the border of the sponge, which forms a kind of cup, the handkerchief, rising an inch or more above the level of the sponge, allows the mouth and nose to be buried in it, with- out the sponge coming in contact with the face, while it adapts itself to the varied outline of the face, and thus prevents air getting in beneath, which thus passes easily through the sponge, and becomes charged with the vapour. It is held by the hand closely applied over the mouth and nose, and the amount of dilution can be regulated by compressing the sponge, which prevents the air passing through so freely as it otherwise would, or by raising it from the face. The chloroform is poured over the inner side of the sponge; but it can, during the process, if more is required, be poured on the outside while ira situ over the patient’s countenance.-I am, Sir, your obedient servant, Devon, February, 1855. M. R. C. S. To the Editor of THE LANCET. SR,—In a letter on " The Administration of Chloroform in London and Edinburgh," which you published on the 27th January, Dr. Snow remarks-’’ I have only seen a single case in which the person administering chloroform seemed to rely for his information chiefly on the state of the pulse." Many of your readers, doubtless, have read this statement with surprise. I believe everyone who has had opportunities of comparing the practice of the London hospitals with that of ! the Edinburgh Royal Infirmary, will allow that in the latter ’ institution alone is the pulse disregarded. The practice of ’ appealing to the circulatory system, for information as to the patient’s condition-be that practice right or be it wrong-is ! assuredly prevalent in London and discarded in Edinburgh. l If in Edinburgh the pulse be regarded at all, it is from mo- - tives of curiosity. But, in proof that in London it is other- - wise, many authorities might be cited. Take, for instance, the directions for the administration of chloroform, laid down by the surgeon to University College Hospital. Mr. Erichsen maintains (Science and Art of Surgery, p. 49) that-" During ’ the whole time it is the duty of the administrator to keep his r hand on the pulse. "-I am, Sir, yours obediently, e Edinburgh University, Jan. 30tb, 1855. HOPEWELL. HOPEWELL.
Transcript of Reviews and Notices of Books
187
Reviews and Notices of Books.Reviews and Notices of Books.Unsoundness of Mind in Relation to Crimiatal Acts. An
Essay, to which the First Sugden Prize was this yearawarded by the King and Queen’s College of Physicians inIreland. By JOHN CHARLES BUCKNILL, M.D. Lond., Phy-sician to the Devon County Lunatic Asylum, pp. 148.London: Highley. 1854.
IN these teeming days of authorship, when treatises appearon a single symptom of disease, and the copious flow of words’forms so remarkable a feature in the literature of medical
science, the perusal of a little book written in a terse, vigorous,logical style, is absolutely refreshing.
Of Dr. Bucknill’s essay, we may say that its principal faultis the very unusual one of being too short. Yet we are not
aware of any points of interest or importance which he hasomitted, or which he has failed to illustrate with originality ofthought and with the authority of experience.
In the earlier pages, the author proves the fallacy of thecurrent legal definitions of insanity, and that all metaphysical Idefinitions must, of necessity, be unsound and insufficient.He then seeks to establish his own view of unsoundness of
mind, the peculiarity of which consists in the prominence hegives to the " element of disease." Society does, indeed, re-cognise insanity to be a disease of the body, or the care of thosesuffering from it would still be intrusted to spiritual guides.
"Medical men experienced in the phenomena of insanityare not examined in courts of justice, because they may, tosome extent, be mental philosophers, and acquainted with theorigin of crime, the laws of responsibility, and such matters;but because they are physicians, and supposed to be capable ofdetecting the existence of disease."
So far as we know, Dr. Bucknill is the first writer on thissubject who has insisted on the paramount importance of re-garding criminal lunacy as a manifestation of diseased brain.Phrenological writers have made it dependent upon irregularcerebral function; but they disregarded the " element of dis-ease," and on this they fell short of the truth. Their doctrineswould extend irresponsibility to all men for their acts; where-as, it is only for actions which are the result of disease forwhich this can justly be claimed.As to the mental tests of insanity, Dr. Bucknill distinctly
states that none of them are trustworthy. He savs-
judges, to meet cases where responsibility is diminished bypartial disease; and that in these trials the judges should beassisted by medical experts, as in the Admiralty courts, thejudges are aided by the Trinity masters, acting as amici curiœ.
Dr. Bucknill urges the establishment of a state asylum inthis country. In this respect we are behind Ireland, wherethey have an excellent institution of this kind at Dundrum."In England, men who escape the punishment of heinous
offences on the plea of insanity, are, for the most part, con-
signed to the criminal ward at Bethlem; a place which hasbeen justly referred to as a receptacle of insane criminals.
" It is not a modern prison, for there is no corrective disci-pline ; it is not an hospital, for suitable treatment is impos-sible ; it is not an asylum for the relief and protection of theunfortunate, for it is one of the most gloomy abodes to be foundin the metropolis. It is simply a receptacle, into which thewaifs of criminal law are swept, out of sight and out of mind."Good sense and liberality of opinion, guided by practical
experience, pervade the book, and we strongly recommend itsperusal both to medical men and to lawyers.
ADMINISTRATION OF CHLOROFORM.To the Editor of THE LANCET.
SIR,—The particulars of several of the fatal cases of chloro-form bear out the statement of Mr. Syme as to the imperfectmanner in which it is frequently administered. It is pouredon a piece of lint, and the vapour inhaled in a volume : the lintbeing comparatively impervious to air, does not allow of itsbeing sufficiently diluted, and the patient’s inhaling a sufficientamount of the surrounding air depends on chance or accident.Considering the powerful poisonous effect of undiluted, orinsufficiently diluted chloroform vapour, as shown by variousexperiments on animals, the marvel is that deaths have notbeen more numerous; but we may hope that the attentionnow drawn to the subject will lead to the more careful admi-nistration of so potent an agent.To guard against such dangers, I have generally used an open
sponge, of a triangular shape, about three inches long and twoinches wide at the lower part. A piece of lint, or a handker-chief folded up lengthwise, about an inch and-a-half wide, iswrapped round the border of the sponge, which forms a kindof cup, the handkerchief, rising an inch or more above the levelof the sponge, allows the mouth and nose to be buried in it, with-out the sponge coming in contact with the face, while it adaptsitself to the varied outline of the face, and thus prevents airgetting in beneath, which thus passes easily through the sponge,and becomes charged with the vapour. It is held by the handclosely applied over the mouth and nose, and the amount ofdilution can be regulated by compressing the sponge, whichprevents the air passing through so freely as it otherwise would,or by raising it from the face. The chloroform is poured overthe inner side of the sponge; but it can, during the process, ifmore is required, be poured on the outside while ira situ overthe patient’s countenance.-I am, Sir, your obedient servant,Devon, February, 1855. M. R. C. S.
To the Editor of THE LANCET.
SR,—In a letter on " The Administration of Chloroform inLondon and Edinburgh," which you published on the 27thJanuary, Dr. Snow remarks-’’ I have only seen a single casein which the person administering chloroform seemed to relyfor his information chiefly on the state of the pulse."Many of your readers, doubtless, have read this statement
with surprise. I believe everyone who has had opportunitiesof comparing the practice of the London hospitals with that of
! the Edinburgh Royal Infirmary, will allow that in the latter’ institution alone is the pulse disregarded. The practice of’ appealing to the circulatory system, for information as to the
patient’s condition-be that practice right or be it wrong-is! assuredly prevalent in London and discarded in Edinburgh.l If in Edinburgh the pulse be regarded at all, it is from mo-- tives of curiosity. But, in proof that in London it is other-- wise, many authorities might be cited. Take, for instance,
the directions for the administration of chloroform, laid down_ by the surgeon to University College Hospital. Mr. Erichsen
maintains (Science and Art of Surgery, p. 49) that-" During’ the whole time it is the duty of the administrator to keep hisr hand on the pulse. "-I am, Sir, yours obediently,e Edinburgh University, Jan. 30tb, 1855. HOPEWELL.HOPEWELL.
![REVIEWS AND DESCRIPTIONS OF TABLES AND BOOKS …€¦ · REVIEWS AND DESCRIPTIONS OF TABLES AND BOOKS 42[F] ... and the reviewer noticed no serious errors. ... Chapter III. Matrices](https://static.fdocuments.net/doc/165x107/5b6a40997f8b9af64d8bcc3a/reviews-and-descriptions-of-tables-and-books-reviews-and-descriptions-of-tables.jpg)
