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TO THE EDITOR OF THE MEDICO-CHIRURGICAL REVIEW.

London, December 18, 1841. SIR, I was much astonished that a London Medical Journal (the Lancet) of which a political Journal, the Times, appears to be the echo, should so impudently and abusively defend the system of " non-restraint" in the treatment of all cases of mental alienation, whilst no one has taken upon himself to undeceive the readers of the Lancet, on a system vaunted in opposition to all good sense and truth, by the "Looker-on, and Snap, &c." It may truly be said from the extravagance of their language, that one might expect every intelligent and impartial man would do them justice. The public, however, are not always impartial and just, but too often inclined to pronounce in favour of those who trumpet those sonorous words, humanity, philanthropy, &c.

I therefore took it upon me to defend the cause of truth, but I had reckoned without my host. I was ignorant of the principles of my adversaries, I was then unaware that fairness and integrity formed no part in their cause. I sent a reply to "Looker-on," which was advertised in the Lancet for insertion the following week, but I suppose in the meantime the "Looker-on" had been consulted, and instead of my letter, appeared an announcement diametrically contradicting that of the previous week, by stating that it would not appear in that Journal.

I am informed it is not the first time such means have been employed, and it is unnecessary for me to comment upon them. The public will be their judges, if you will have the goodness to insert in your valuable Journal a copy of the letter which has been refused by the Editor of the Lancet; I would have given it literally, but as I have before said, I was ignorant of the principles of my adversaries, and neglected to preserve a copy, the sense, however, which I give from memory, is unaltered.

To the Editor of the Lancet.

"Ne sutor ultra crepidam."

SIR,-In addressing you on a subject which has lately occupied a conspicuous place in the columns of your Journal, permit me to assure you that I am not only perfectly disinterested on the subject I defend, but a stranger in the country which has given birth to opinions so diametrically opposed to each other. I read attentively from one end to the other the lengthy epistle of the "Looker-on," and my first impression was "sunt verba et voces ;" on a second reading, I concluded not only that the " Looker-on," whoever he may be, is entirely ignorant of the treatment of mental diseases, but that he has never had any insane persons under his care; and I venture to assert that which I shall prove in proper time and place, that he is acting the part of the cobbler, who thought the leg extremely ill made on being asked his opinion as to the form of the boot. I have so great an antipathy to discussions unfairly conducted-I am so deeided an enemy to contests in which one of the adversaries treacherously conceals himself behind a curtain, that on the one hand I am induced to speak to him with severity, but yet with justice, whilst on the other I feel compelled to take up the cause of two experienced and estimable men,* and to become the echo of that one and only opinion which must prevail in the treatment of mental disease. My peculiar position permits me fearlessly to declare my opinions in opposition to those of the "Looker-on," who is unable to draw on me the animadversion of a public always greedy for the "beau ideal," and always the dupe of those who, in their comfortable mansions, seated by a good fire, and after a generous dinner, accompanied by copious libations of the "wine that cheereth," set themselves up as defenders of suffering humanity. Nothing is more easy to a writer unacquainted

The letter of "Looker-on," was an attack on the Nottingham Report, by Dr. Blake and Mr. Powell.

with his subject than to mislead on words: the "Looker-on" possesses the organ qualifying for this task in an extraordinary degree of development. I am not aware to what degree my own cranium is furnished with such protuberance, but however that may be, I have long since learned to neutralize the influence of this organic tendency, by going straight to facts, and by addressing myself immediately to the men or things I attack, that is to say, I am not possessed of that courage which would lead me to conceal myself by an anonymous name for the purpose of making myself more formidable.

It is a general opinion in my country, and possibly is the same in England, that one secret opponent is more to be feared than ten enemies face to face, or, to make use of an allegory very applicable in this case, the serpent treacherously veiled beneath the leaves is more to be feared than the lion who shows his fine though formidable teeth. In entering on my subject, I would first place it in a fair and just position. I shall be concise, for I shall certainly not commence a discussion without proof that my time will not be thrown away. The subject is undoubtedly beyond the reach of ordinary understanding and experience. I may, if hastily judged, be accused of presumption, but it should be understood I will leave the "Looker-on" no door of escape. He must give his name. He must take up the glove I throw down, and come fairly and loyally into the arena. He must bring forward arguments capable of proof, otherwise I should be compromising our noble profession. I should be degrading myself in my own eyes if I could descend to the ground with one who has not the honesty to avow his

own name.

One more paragraph, Sir, and I finish a letter which must only be considered as preliminary, and if the " Looker-on" is really a man who has a proper sense of his own dignity, and the importance of the cause he professss to advocate, he will appreciate my motive in endeavouring to lead him to conduct his argument scientifically, and prevent my having the power to apply to him "critiquer est aisé mais juger est difficile." Every man is not an author, and there are many enlightened members of the medical profession, who are unable clearly to define their ideas on paper, and sometimes they express that which is very unlike what they intend to convey, but with me and with every honest man "le sentiment fait tout," and I care little as to the manner in which it is expressed, still more in a doubtful case. I would adopt the best sense :-thus whether Dr. Blake and Mr. Powell have given their opinion clearly or not, I do not trouble myself to decide, and should never think of amusing your readers with two columns of words on a phrase more or less equivocal.

This unfortunate phrase in the Nottingham Report I read, and I understood or wished to understand that these geutlemen were of opinion that restraint may be useful and must be necessary in certain cases of insanity, but that the physician ought always to use it with discretion. This last phrase, Šir, is the burden of the "Looker-on's" letter, while at the same time it represents the actual state of the question relative to the treatment of mental disease.

Moral and physical restraint ought to be in the hands of the enlightened practitioner what poisons and powerful medicaments are with the experienced physician, and what fire and steel are in the hands of the skilful surgeon, "voila ma thèse❞—and I do not fear to defend it victoriously against the "Looker-on" upon the above-mentioned conditions. If he has been led to believe that restraint may be abandoned in all cases, he only requires to be undeceived, and in conclusion I repeat I must have a name and not a "Looker-on "-facts and not "verba et voces a man of science, and not a "sutor ultra crepidam." I have the honour to be, Sir,

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Your obedient Servant,

CROMMELINCK, M.D.
One of the Editors of Annales de Medecine
Legale, d' Hygiene Publique et Privée, et
de Maladies Mentales.

OF THE

MEDICO-CHIRURGICAL REVIEW,

No. LXXII. APRIL 1, 1842,

[BEING No. XXXII. OF A DECENNIAL SERIES.]

REVIEWS.
I.

Third Annual Report of the Registrar-General of Births, Deaths, and Marriages in England, with Appendices

1. Deaths, Births, and Marriages in 1840

2. Of the Causes of Death in England and Wales

A. Violent Deaths

B. Deaths in the London Hospitals

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3. Diseases of Towns and of the open Country

A. Influence of the Seasons

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II.

The Administration of Medical Relief to the Poor, under the Poor-Law Amendment Act, &c.

III.

Statistical Reports on the Health of the Navy, for the years 1830-6, inclusive. Part II.

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1. Cape of Good Hope and Coast of Africa

2. Aggregate of the seven years

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1. Hydropathy; or the Cold Water Cure, as practised by Vincent Priessnitz, at Graeffenberg, in Silesia. By R. T. Claridge, Esq.,

II. Establishment Hydro-therapeutique de Marienberg, pres Boppart sur le Rhin.

Dr. Schmitz

305

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309

318

319

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324

358

359

361

362

V.

Memoires de l'Academie Royale de Médicine.

Tome IX.

369

1. Report of the Committee upon the Epidemics which have prevailed in France during 1839-40. By M. Bricheteau

369

2. A Memoir of several recent Trials for Poisoning by Arsenic. By M.

Orfila

371

4. Aneurism at the Origin of the left Carotid treated by Ligature on the
Distal Side. By M. Colson.

3. Ligature of the Common Carotid Artery, for an Erectile Tumour of the
Orbit. By M. Jobert

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5. Ligature of the Common Iliac, for an Aneurism of the External
By M. Deguise

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7. On Menstruation. By A. Brierre de Boismont

9. History of the Discoveries relating to the Venous System from the

6. Disarticulation of the Humerus, Removal of the Scapula, &c. By
Gaetani Bey

376 377

384

time of Morgagni. By A. Raciborski

387

A. Anatomy of the Venous System

387

B. Physiology of the Venous System

c. Pathology of the Venous System

10. On the Effect of a Moral Revulsion in the Treatment of Insanity.

11. A Memoir on the Anatomy of the Brain. By M. Foville

390

393

399

401

12. Anthelmintic Substances employed in Abyssinia. By M. Auber, M.D. 402

13. Reduction of a congenital Dislocation of the Humerus at the end of Sixteen Years. By Dr. Gaillard

VI.

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On Rheumatism in its Various forms, and on the Affections of Internal Organs to which it gives rise. By Roderick Macleod, M.D. 1. Causes and Forms of Rheumatism

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7. Periosteal Rheumatism

VII.

Observations on the Religious Delusions of Insane Persons, &c. By Nathaniel Bingham, M.R.C.S.

VIII.

Researches tending to prove the Non-vascularity and the peculiar uniform Mode of Organization and Nutrition of certain Animal Tissues, &c. By Joseph Toynbee, Esq.

1. First Class of Non-Vascular Animal Tissues

A. Of Articular Cartilage and Fibro-cartilage

2. Second Class of Non-vascular Animal Tissues

A. Of the Cornea

B. The Crystalline Lens

c. The Vitreous Body or Humour

3. Third Class of Non-vascular Animal Tissues

A. Epithelium, Epidermis, Nails, &c.

IX.

Moral Revulsion in the Treatment of Insanity. By F. Leuret, &c.

X.

An Inquiry into the Nature and Pathology of Granular Disease of the Kidney, &c. By George Robinson

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Clinical Researches on Auscultation of the Respiratary Organs, and on the First
Stage of Phthisis Pulmonalis. By Jules Fournet

1. On the Physiological Sonorous Phenomena of Respiration
2. The Morbid Sonorous Phenomena of Respiration

3. Diseases of the Bronchi

4. Diseases of the Pulmonary Tissue

XII.

On the Treatment of Stone in the Bladder, by Medical and Mechanical Means. By R. Willis, M.D.

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1. An Exposition of the Pathology of Hysteria, and of Hysterical Amaurosis.

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3. Pathology

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2. A brief Memoir of George Birkbeck, M.D. By Henry Clutterbuck, M.D. 3. A Treatise on Dislocations and Fractures of the Joints. By Sir A. Cooper, Bart. 496

Spirit of the Foreign Periodicals, &c.

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2. On the Physiology of the Nervous System: Confirmation of Sir C. Bell's Views 503 3. Letter from Mr. Shaw on M. Longet's Work, with remarks on the Mode of conducting Physiological Observations

4. Inauguration of the Statue of Broussais

5. M. Louis on Typhoid Fever

6. M. Andral on the changes of the Blood in Disease

1. The Sanguineous Temperament

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2. The Lymphatic Temperament and Anæmia

3. State of the Blood in Fevers

7. M. Double on the Study of the Greek and Roman Medical Authors

8. On some of the most important discoveries of Galen

9. Galen's Report of a Case of Hepatitis

10. Biographical Notice of Richerand, his Disputes with Dupuytren, &c.

11. Memory of M. Sanson

12. Circumcision as practised at Constantine

13. Transmission of Glanders from one Human Subject to another

14. Hints for the Treatment of Diabetes Mellitus

. 507

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15. Fatal Case of Acute Pleurisy and Effusion; with practical Remarks on this Disease

16. Cases of Milky Urine

17. Recent Works on the Plague

18. Predisposing Causes of Pulmonary Consumption

19. New Theory of Tinea; its supposed Vegetable Origin

Clinical Review and Hospital Reports.

DUNDEE ROYAL ASYLUM FOR LUNATICS.

1. Twentieth and Twenty-first Annual Reports

1. Causes of Insanity

2. Consulting Patient's Tastes and Habits

3. Non-restraint System

4. Delusions of the Insane

GENERAL HOSPITAL AT PICOLATA.

2. Report of a Case of Axillary Aneurysm. By C. M'Dougall, M.D. 3. Clinical Remarks of M. Velpeau on Abscess of the Iliac Region

1. Causes of Iliac Abscess

2. Seat of the Abscess

3. Abscess in the Abdominal Walls

4. Abscess in the Iliac Fossa.

ROYAL BERKSHIRE HOSPITAL.

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6. Successful amputation during the progress of Traumatic Gangrene. By Mr. Toogood.

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