The study of mental disease : being the introductory lecture delivered in the University of Edinburgh on the institution of the Lectureship on Mental Diseases, May 1879 / by T.S. Clouston.

Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The study of mental disease : being the introductory lecture delivered in the University of Edinburgh on the institution of the Lectureship on Mental Diseases, May 1879 / by T.S. Clouston. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Cresswell Cresswell once decided that it was a sine qua non of a valid and legal certificate according to English law.1 And it is not as if the signing of a certificate of lunacy were a matter of rarity. There were at the beginning of last year 83,539 persons under cer- tificate as insane in the United Kingdom. This number required 100,117 medical certificates, or an average of at least five certificates to each practising member of our profession. This takes no account of the certificates granted in the cases of patients that have recovered or died, and no account of the certificates of mental incompetency or competency that have to be granted for other reasons than placing a patient under care. The signing of such certificates is one duty, but not the most important that falls to medical men in relation to mental disease. The mental hygiene of individuals, families, and society, the early recognition of mental symptoms, their suitable treatment, the precautions that have to be taken to prevent accidents and risk of life, the solution of the most important question of home or asylum treatment, the confidential family advice as to professions and careers in life, and as to the formation of engagements and marriages, the grave decisions that have to be come to as to questions of civil and testamentary capacity and criminal responsibility—all or any of these questions you may have before you at any time after you receive your medical qualification. When we consider that one in every 300 of the population is a registered certified lunatic, and that 1 in 30 of those who attain the age of 20 ultimately become inmates of asylums,2 the marvel is how our profession has hitherto got along so well with so littie systematic teaching or clinical experience of mental disease. We must remember that for every person who is obviously insane there is probably another who has been threatened at some period of his life with its symptoms, or labours under more harmless and less obvious varieties of it. If this vast mass of brain disease is not worth study, let the general profession be freed from responsi- bility in regard to it; if this cannot be done, then in the name of all that is reasonable let its study find a place in every medical curriculum, as urged by the Earl of Shaftesbury, the veteran head of the English Lunacy Commission for the past forty years, and by almost all the medical witnesses of repute who gave evidence before the Lunacy Law Committee of the House of Commons of 1877. But for invidious comparisons, I think that I could show that there is more than one subject which medical students have now to study, and on which they undergo searching examinations that cannot compare in practical importance with mental diseases. 1 The designation and residence, marked 4 in the statutory form. The legal importance of this part consists in the fact that it is the only part of the certi- ficate where the patient is individualized and identified. Suppose John Brown is being certified without his designation and residence, what means is there of lggally distinguishing him from the thousands of the same name in the country 1 * Dr Chapman, Jour. Meat. Science, April 1879.