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

  • Thomas Laycock
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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    stitute the chief part of the incorrigibles in the criminal population. They are all held in law to be entitled to uncontrolled freedom; and thus the criminal imbeciles, as well as the vicious, become more certainly mischievous to society. Practically, under the influence of this principle, detention and restraint would still be the fate of the criminal population, but mercy and not vengeance would be the aim and the result of its operation. There is yet another question I must touch upon. You will have observed that the Lord Chancellor spoke of “ mad doctors ” when he wished to designate those members of the medical profession who, like the philanthropic Dr Conolly and others, are specially occupied with the treatment of mental diseases and defects. It is undoubtedly a contemptuous term of vulgar origin, and one cannot understand why it should be so readily and so freely used in such high quarters. Even another noble lord occupying the high official position of Chairman of the Commissioners in Lunacy for England not only used the term, but expressed himself in a manner which must be held to be unfavourable and disparaging to the whole medical profession. The Earl of Shaftesbury is reported to have said, that “ from his own experience of many years on the Commission of Lunacy, he could affirm that medical men who had not made the subject a special study, were as ignorant of mental disease as any one who observed it for the first time.” And then the noble commissioner, forgetting the exception he had made in his sweeping denunciation of the profession at large, in favour of the specialists, proceeded to detail the particulars of a case in which he differed in opinion with a specialist as to whether a certain lady was insane, and remarked, “ a person calling himself a mad doctor, said the lady must be insane, because she wore a dagger.” The noble commissioner is undoubtedly misreported here. It is inconceivable that any physician specially engaged in the management and treatment of the insane would designate himself by so vulgar and contemptuous a title as “ a mad doctor.” Nay, it is almost inconceivable that the noble lord would use such a term himself in speaking of a physician of this class. For any language which tends to bring the status of such physicians into contempt, tends necessarily to limit their usefulness, while, at the same time, it deters the best minds from entering upon that department of practice. The phrase “ mad doctor” has also its effect upon those whose misfortune it is to be deprived of their reason ; because calculated to obstruct that flow of sympathy and kindness which they especially need more than any other of the sick and infirm. Any one acquainted with the insane knows what tact, what skill, what moral courage and fortitude, and what thorough conscientiousness are needed in their attendants and guardians, and how difficult it is to meet with persons who have these necessary qualifications. But if madmen, madhouses, and mad doctors be brought into contempt by the language used in high quarters, how greatly are the difficulties increased in this respect! Of this the noble commissioner must be fully aware, simply as a person of common sense conversant with the world, and having a practical knowledge of mankind, if not of asylums, for I presume the visitation of these is not included amongst his Lordship’s duties. But a more terrible evil is inflicted upon the insane even before they reach an asylum. It is the peculiarity of insanity as a disease, that it cannot be treated effectually at home, or with the concurrence of the patient; he must be with- drawn, usually against his will, from all those stimuli to excessive mental and cerebral activity, which, probably, have mainly caused his malady, and which he too vigorously seeks. Hence the need that he be removed to a suitable place where his over-excited brain may have rest. Now, what is the effect on treatment and cure of this contemptuous discredit of lunatics, their asylums, and their physicians ? The patient and his friends look upon the adoption of the best and only means of cure as a frightful calamity; they dread the stigma
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