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asylums, both public and private, who are less dangerous to themselves and to society, more amenable to motives, possessed of more selfcontrol, more rational, in short, in every respect than the thousands of oinomaniacs who now infest society uncontrolled? wasting their own property and the property of others, ruining their families, displaying without hinderance the "inhumanitas," "ferocity," and moroseness" of the insane drunkard, and transmitting to their wretched offspring their own morbid cerebral organization, as a Pandora's box from which a host of miserable disorders will inevitably arise. If maniacal irresponsibility be the necessary and proper ground for restraint, then that ground is amply shown and undeniably demonstrated in the natural history and mental pathology of the oinomaniac. As to the general propriety and advantage, therefore, of restraint in these cases, no practical man can doubt.

The decision as to the propriety of subjecting any individual drunkard to restraint might be left in the hands of two medical practitioners expressly appointed to that duty, rather than to a jury, provided fixed principles for the guidance of their judgment were laid down. They would have to determine in the first instance the facts of the case by personal investigation and inquiry, and from these facts deduce the general conclusion that the sufferer has lost all power of self-control, and is destroying his health to a dangerous extent, utterly neglecting his domestic or social duties, and ruining his patrimony, whether it be in real estate, in personalty, or in the less tangible form of businessconnexions. In multitudes of instances, the facts and conclusions. would be found to be equally obvious and inevitable.

It is a much more difficult question to determine the extent to which seclusion and restraint of the oinomaniac should be carried, for the very obvious reasons that while a very short period of total abstinence from intoxicating drinks often suffices for the restoration of the patient to a rational condition, even when insanity of a decided character has been the result of intemperance, a relapse into drunken habits is almost certain if an early dismissal takes place, which, in fact, it is difficult to avoid; for why should you restrain a person from the exercise of his freedom, it is argued, who is perfectly rational, truly sober, and quite determined never again to yield to temptation? Nor should it be forgotten that popular opinion runs strongly against any detention of the kind whatever, on the ground that it is an invasion of the liberty of the subject, and that a man has a right to get drunk if he likes. In the Report of the Commissioners for 1844, the liberation of patients rendered insane by intemperance is discussed, and the following instance, as one involving great perplexity, is mentioned. At a licensed house in Yorkshire the visiting justices liberated

a dangerous lunatic, who had been placed therein at the instance of his wife. The man had been in a state of continued drunkenness for many weeks; he had threatened the life of his wife and child; and two of his brothers had died insane. The compulsory abstinence of the establishment had its proper effect, and when the visiting magistrates saw him, they entered their opinion in the Visitors' book to the effect, that "he appears to be perfectly sane at present, and unless sufficient cause for his further detention be shown to the magistrates assembled in petty sessions, he was to be discharged;" and discharged he was accordingly. The result was, that he again threatened the life of his wife, drove her from his home, and was again placed in the custody of the constables. As precisely the same difficulty would arise in dismissing the ordinary oinomaniac as the drunken madman, we subjoin the results of the experience of the Commissioners in reference to the latter:

"The difficulty which we have experienced has been to determine for how long a period the patient ought to be detained in confinement after his malady has apparently ceased. We have thought it desirable that he should not be exposed too soon to the temptation of again indulging in strong liquors; it having been almost invariably found that patients of this class, if liberated without having undergone a sufficient probation, are very liable to resort to their former practices, and to relapse. At the same time, 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 their liability afterwards to run into their former excesses when restored to liberty. It has been our practice, in cases of this sort, to liberate the patient after a short confinement, if it be the first attack of insanity from this cause, and if he appear to be aware of his misconduct, and to have a desire to reform his habits. In the event, however, of his being confined a second time owing to the same cause, we have felt that his probation ought to continue for a much longer period; and indeed we have felt great responsibility has rested upon us in such a case, and have at all times very reluctantly, and only after vainly endeavouring to induce the patient's friends to take charge of him, resorted to our power of liberation."-(p. 175.)

The great tendency to relapse is in fact the main difficulty, for it is known that the insane drunkard is specially liable to this. Sir W. Ellis mentioned to the Parliamentary Committee the case of a man dismissed cured from Hanwell. He remained well for twelve months, then began drinking spirits again, and stabbed a policeman, for which he was committed to Newgate. He again recovered, again relapsed, and was re-committed to the same prison for similar misconduct. Mr. William Collins, vice-president of a Scottish Temperance Society, stated to the same Committee, as the result of his experience of drunkards, and as "a well-established physical fact," that the drunken

appetite, when once formed, never becomes completely extinct, but adheres to a man through life.

"If he abstains entirely from spirits, the appetite will not annoy him; its insatiable cravings and the uneasy sensations of the nervous system will cease; but if after ten years' abstinence he take a glass of spirits, his appetite, like tinder, will ignite with the first touch, and flame out again. Hence the danger to which drunkards are exposed, * *** as we find that at one time or another, when they have been drunkards before, they all fall by the slightest temptation or inducement to taste."

*

Dr. Hutcheson's experience is very similar to this. He remarks of the chronic form

"I have seen only one case completely cured, and that after a seclusion of two years' duration. In general it is not cured; and no sooner is the patient liberated than he manifests all the symptoms of the disParadoxical though the statement may appear to be, such individuals are sane only when confined in an asylum.'

ease.

This practical question is of so great importance that it ought to be placed on a scientific basis by instituting a more careful inquiry into the etiology, pathology, and treatment of oinomania, with a view to what may be termed its prognosis; or, in other words, from an examination of the nature, causes, and progress of the disease in each particular case, to deduce safe conclusions as to the amount of self-control that can be ultimately exercised. Although nothing very definite is to be found in books, certain general principles may be deduced from the vast mass of facts recorded. Primarily, and most important of all, arises the question of causation in reference to the condition of the cerebrum. If the brain be permanently defective, then the prognosis is bad, for the organ itself of the will and of the understanding is inherently feeble. Now permanently defective conditions of the cerebrum may be induced by numerous causes. Long continued stimulation by nervine stimuli is one; hence it is that the confirmed drunkard is usually irreclaimable. Injuries to the structure of the brain, whether from mechanical causes, from coup-de-soleil, from fever, or from diseases of the encephalon, which induce a constantly recurring morbid condition of the vascular system, as epilepsy, may be placed in the same category. The occurrence of actual insanity, or a known hereditary predisposition thereto, renders the prognosis very doubtful. A natural or inherent condition of the nervous system, such that the appetite for pleasurable feelings is intense, the sufferings from painful sensations great, the foresight defective, and the will feeble, strongly predisposes to relapse. We may here remark incidentally, that persons of this class who have irregularly formed heads and heavy lips, the upper one enlarged, the lower somewhat tumefied and everted, are amongst the

most incurable. Oinomania in the parents-one or both-or even what is termed a "moderate" use of spirituous liquors long continued, is of unfavourable omen, for the morbid condition of the cerebrum most assuredly caused by the latter is readily transferred to the children. Where the daughters of a drunkard are nervous and hysterical (as they very often are), and the sons weak, wayward, eccentric, and extravagant, relapses from continuous oinomania are likely to be severe and persistent in any of the family attacked.

To be continued.

ART. II. THE RESPONSIBILITY OF THE INSANE.* WHAT is the condition that releases a man from responsibility to the laws of society?

Notwithstanding many conflicting arguments and decisions, medical and legal, we may affirm that this question is practically solved, both according to the practice of the law and the dictates of common justice, when insanity is established. Although not convertible terms, insanity and irresponsibility are inseparably associated. Irresponsibility follows upon insanity as a logical necessity. We should, therefore, hold that the difficulty would be overcome could we expound clear and definite rules by which insanity might be known. But, in discussing this question, so momentous to society and to individuals, with the authors the titles of whose works are quoted below, we shall be compelled to consider it under another and still more complicated aspect. Dr. Mayo and Dr. Bucknill, in express terms, contend that there are certain states in which responsibility is only modified, and not annulled. They would break down the old barrier which has hitherto been deemed the natural, and served as a recognizable boundary between responsibility and irresponsibility. That barrier removed, we shall have to call upon Dr. Mayo and Dr. Bucknill to show us how far we are to travel along the road beyond the confines where sanity ends and insanity begins before we arrive at the vanishing point of responsibility. We shall have to ask them to define at what degree of madness they would interfere to stay the infliction of punish ment. We greatly fear that, the only intelligible landmark removed,

By Thomas

1. Medical Testimony and Evidence in Cases of Lunacy. Mayo, M.D., F.R.S. London: John W. Parker and Son, 1854. 2. Unsoundness of Mind in relation to Criminal Acts; being the Sugden Prize Essay for 1854. By John Charles Bucknill, M.D., Physician to the Devon County Lunatic Asylum. London: Samuel Highley, 1854.

3. Unsoundness of Mind in its Medical and Legal Considerations. By J. W. Williams, M.D. Dublin Quarterly Journal of Medical Science, Nos. XXXV., XXXVI., XXXVII. 1854-5.

we shall, like benighted travellers, have to grope our way in a dreary wilderness of speculation,-no point of departure, no guiding star, no compass, no resting-place, no progress, and no goal! Can the search for the conditions of responsibility be hopeful or profitable if thus undertaken? We fear not; but, nevertheless, we cannot shrink from the task of examining the proposition as presented to us by the authors we have named. Nor do we desire to shrink from it. The doctrine maintained by them is fraught with consequences to society too mighty, and, we think, perilous, to permit us, in conscience or in inclination, to evade it, or to pass it by without ample investigation.

We would not call down upon these authors the penalties invoked by the ancients against those who removed the Terminal Gods. We venerate the principle of liberty of thought; but we cannot, reflecting upon the subversive tendency of the doctrine we are about to discuss, avoid uttering our deep conviction that it is one that ought not to be promulgated unless supported by very cogent arguments.

In entering upon the task as presented to us, we are still, however, not freed from the necessity of seeking to determine the essential conditions of insanity as the first step in the inquiry. Even the authors we have named, although contending that responsibility passes into the cloudy regions of insanity, and unable, as may well be imagined, to indicate at what precise step of insanity responsibility ends, cannot escape from this elementary necessity. We could not, indeed, appreciate their reasons, or do justice to their arguments, unless we began by inquiring what it is that they understand by the term, insanity.

Both have, with a fatal courage, dared to enunciate definitions. Every man who throws down a definition challenges criticism. But first, we think it our duty to cite the passages in which they explain their doctrine of responsible madness. Dr. Mayo is precise, and even dogmatic. There is none of the diffidence of doubt; he lays down his doctrine with all the assurance of a man who has established it on the basis of scientific demonstration, with all the confidence of a Columbus who has made a discovery in advance of the intelligence of the age in which he lives. In his preface, Dr. Mayo tells us-" In the course of my inquiries I have been led to certain conclusions, for which I cannot expect a cordial or immediate reception." "The second (of these conclusions) arises out of the question whether some offences of the insane ought not to be visited with some form of secondary punishment." "The law will remain a dead letter, or be continually ignored by the sympathies of judges, juries, and, I may add, of medical witnesses, unless some practical distinction can be arranged which may enable the responsible insane to undergo some lower degree of punishment than that inflicted on similar delinquents being of sound mind,"