The antagonism of law and medicine in insanity, and its consequences : an introductory lecture / by Thomas Laycock.

  • Laycock, Thomas, 1812-1876.
Date:
1862
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Licence: Public Domain Mark

Credit: The antagonism of law and medicine in insanity, and its consequences : an introductory lecture / by Thomas Laycock. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    that will thereby attach to him and his children, if the head of a family, and too often the removal from home takes place at last when all hopes oi cure are gone. How often do we see a sound understanding wrecked, estate wasted, a family impoverished, and the stigma finally incurred in its most aggravated torm, when a few weeks early and suitable treatment would have saved all! The Lord High Chancellor was justly eloquent as to the expenses alleged lunatics were made to incur by judicial inquiries; the whole system is in truth a disgrace; but what is the loss of a few thousands of pounds when compared with the mental agony and slow torture, ending finally in mental death—worse than death itself—which the educated lunatic is too often thus most unnecessarily compelled to endure ? It is not possible to estimate the benefits which would accrue to thousands of individuals, and to the public at large, if all these prejudices were removed, so that the sufferer from impending mental disease could at once avail himself ot the best means of cure as readily as if lie had a pleurisy. It is a horrible thing to witness, as I have witnessed, the gradual clouding over of a fine intellect, and to hear the poor patient exclaim, with the late George the Third, who drew his son, the Duke of York, aside, and bursting into tears, said—“ I wish to God I might die, for I am going mad ! ” 1 ll But setting aside the argument of kindness and sympathy for these sad sufferers, it is of importance that early treatment should be facilitated in every possible way, from pecuniary considerations. The numbers of the insane living are con- stantly increasing—partly from increase of population, partly from the longer duration of life of the insane—so that asylums cannot be built fast enough or large enough for the incurables who are destined to linger on for many years in seclusion, and often despair. The remedy for this increase is twofold—namely, a more general knowledge of the nature of insanity, and of what induces it, and prompter treatment in the early stages by the ordinary practitioner. Whatever obstructs these essentials adds, in truth, to the national burden ; whatever facili- tates them tends to diminish it. Now, if the public has done little in this direction, I think the heads of the medical profession might have done more than they have. Unquestionably, it is an exaggeration to say, with Lord Shaftesbury, that those medical practitioners who are not specially engaged in the management of the insane, are as ignorant of mental disease as any lay person who has seen an insane person for the first time; for even the delirium of fever, or of wounds, or of the drunkard, is but a kind of mental disorder, and is too often witnessed in ordinary practice, not to teach the medical practitioner something of the nature of mental derangement. Nevertheless, the profession at large, it must be admitted, has not a sufficient theoretical and practical knowledge of the subject. But with whom rests this defect ? The medical student is not required to make mental science in relation to pathology and therapeutics a special study either theoretically or practically; nor is he specially examined in it by the examining boards; and, when called to a case in private practice, he rarely sees its whole course and termination, as the patient is necessarily removed to a suitable house. There is thus no stimulus to the study of mental diseases, or to the scien- tific development of mental science in its practical applications; and in this way it happens that there are such diverse opinions and imperfect theories, and such 1 It is much to be feared that the opinions expressed in the House of Lords will seriously increase the litigation to which the profession is exposed when signing certificates of lunacy, and which lias entailed grievous loss upon Scottish physicians, although successful in the law p ea. An lidinhurgh physician, one only of several defendants in a late law-plea of this llV 'n , .he was successful, has suffered a large pecuniary loss, besides much anxiety f )'v?f , tunv> and lias now to follow his antagonist to the House of Lords, and incur thU ?• ancl expense in meeting the appeal of the pursuer. It is quite certain that I0n.°. “!c practitioner, in the exercise of a painful and thankless duty, is already and ti eafmeut ofXliTiD ^ °f families' interfering with the early removal