Proceedings of the Association of Medical Superintendents of American Institutions for the Insane, at its Thirtieth
Annual Meeting, held at Philadelphia, June 1876. (From The American Journal of Insanity, for October 1876.) The Thirtieth Annual Meeting of the Association was held at the Continental Hotel, in the City of Philadelphia. The condition and progress of the State Asylums for Insane Criminals and the large institutions of the City of New York, were discussed at some length. Pennsylvania, and the New Hospital at W arren were represented by Dr Kirkbride and Dr. Curwen ; West Virginia by Dr Camden ; North Carolina by Dr. Grissom; South Carolina by Dr Ensor ; New Jersey by Dr. Buttolph ; Georgia by Dr Green ; Texas by Dr Wallace ; Ten- nessee by Dr Callender; Kentucky by Drs. Chenault and T^nrViPS.
Amongst the numerous subjects under discussion, the pro- priety of allowing many patients to return to their homes for variable periods m order to be in the midst of their accustomed surroundings, was considered, and Dr Wallace strongly advocates the procedure, since, he says, he is to some extent imbued with Dr Maudsley’s views of asylum-made lunatics.
Dr Denny presented a number of transparent sections of the human brain, conducted in a transverse and vertical direc- tion through both hemispheres, including the cerebellum, pons varolii, and medulla oblongata, illustrating, in a general way, a method of preparation affording the best facilities for studying its minute anatomy, and the variations of form and relation in continuity of the same part at different points.
Dr Eanney, in allusion to softening of the brain, laid stress upon the occurrence of permanent flexion of sets of muscles, such as the flexing of the forearm upon the arm, and the thigh upon the body; and Dr Nichols remarked that it had been stated by Dr Luther Bell, ” that in incipient softening in cases whose termination showed that they were of genuine ramollisement du cerveau ab initio, he usually found contrac- tion of the flexor muscles of one or both thumbs with inversion of the thumbs into the palms of the hands, and that in doubtful cases, when softening was suspected, his diagnosis turned upon the presence or absence of the phenomenon.”
The criminality of the insane occupied considerable atten- tion, and was dilated upon at some length by Drs. Kay, Gray, and others.
In reference to the administration of chloral hydrate, we learn that occasionally the following symptoms are induced, viz., slow emaciation, loss of strength, hesitancy of speech, unsteadiness of gait, indications of cerebral congestion, occa- sional paroxysms of difficult breathing, extensive erythemas, and pustular or papular exanthemata.
Speaking upon the much-vexed question of the treatment and disposal of inebriates, Dr Forbes says: ” I would deal with a confirmed inebriate as I would deal with a lunatic. Instead of a writ reading’ de lunatico inquirendo,’ let it read fde inebrio inquirendo.’ Let a jury decide his case upon evidence and proper proof. When convicted, proceed exactly as with a lunatic, reduce him to the condition of a minor by taking away his estate, if he has any, and placing it in the care of a com- mittee, disfranchise him for the time, strip him of his proud equality among his fellows. Then let him be placed in an inebriate asylum prepared for such cases exclusively, there let him be treated for his malady; that is the way to reform and restore him; and when so reformed and restored, let him go back to his family and friends and society, precisely as a lunatic does Avho has been restored to his healthy mental powers. Reinstate him in his manhood, clothe him anew in all his rights and attributes, but let him feel that he goes back with the inevitable certainty of being returned to the institution when- ever he falls into his former habits.”
The volume before us contains, as will be perceived, a large amount of useful and interesting matter, and is well worthy of the attention of those interested in lunacy movements.
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