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they did not accept the offers made ; conse-quently the said gents’ presumed acceptancefell to the ground : this is the reason whythe secretary says that the board of guar-dians have not yet come to any decision. The

presumed acceptance is answered by our

worthy secretary himself; for he says one isready to withdraw his letter, and that anotheraccepted from a misunderstanding, and wiilfollow the example, therefore I do not thinkthere is any doubt of acceptance.The original error arose from the gents at

one of the first meetings of the medical gents(not of the association) voting against, pledg-ing themselves not to accept (though ourworthy secretary was of opinion they shouldso have done), then there would have beenno withdrawing or explaining. I do notthink I have acted without judgment or goodtaste, as the result has proved ; neither did Iforget that the secretary was instructed towrite to the medical gents in the neighbour-hood : for what would have been their asto-nishment to have joined an association (con-sisting of the same gents who formed themeeting and expressed the opinion they did),to have found the said association hadburked such a subject as medical remunera-tion ; such a fact getting abroad would havedeterred others, much more than my feeblepen, for such things should be taken up byan association in preference to a privatemeeting.As for the grand day at Hampton it is

really quite ridiculous, for several who hadbeen there found time to come to the

meeting; some were seen to pass by whilstthe meeting were waiting for a fuller attend-ance ; and one (an exception) was absolutelyin conversation at the hotel door with someof the meeting, but could not come in becausehe was dusty.For a medical association to have but one

main object is absurd; but to suppose thatthat one object ought to be a library, is quiteas absurd ; and because medical remunera-tion should by chance be the object to drawthe medical gents in the union together, andan association should happen then to be

formed, that such a subject should not betaken cognisance of by such association, be-cause in its first act it would look like oppos-ing the board of guardians, is truly ridicu-lous. Are not the guardians setting a valueon our services and medicines in a manner they do not venture on with other professions,or trades either ? So far ’from. its being mywish or intention to give a blow to our

newly-formed association, I hae every mo-tive to give it stability, and will exert myselfto carry out every resolution which shall addto it, and also the objects of the association,viz., to promote UNION and CORDIALITY

amongst its members, by cultivating kindand friendly feeling and honourable conducttowards each other, and to uphold the dig-

nity, respectability, and usefulness of the me-dical profession.

I really must request our worthy secretarywill not try to gloss over want of unanimityand pusillanimity on so vital a subject, noraccuse me of not having made myself ac-quainted with the circumstances, nor ofjumping to a conclusion. Your obedientservant,

MEDICO-CHIRURGUS.July 11, 1842.P. S.-There is now a notice of motion

in the guardian’s book for a conferencewith the medical gentlemen, but as yet nonames ara stated, but some have been men-tioned.

MEDICO-CHIRURGUS.

PROCEEDINGS

OF

SIR JAMES GRAHAM

IN RELATION TO

CHANGES IN MEDICAL LAW.

To the Editor of THE LANCET.

SIR,—We are at length told from the lipsof Sir James Graham himself that he is pre-pared to bring before Parliament, this ses-

sion, not one only, but several measures,which will alter the whole constitution of themedical profession in this country, and con-sequently involve to a serious extent theinterests of the public at large, as well asthose of the medical man. Yet so meaulydoes he think of the profession, that eitherhe cannot or will not give any precise infor-mation as to the nature of the proposedchanges, until the Bills are actually in thehouse.The general practitioner may well look

forward to these changes with feelings ofunmingled apprehension, when it is knownthat they emanate from the self-styled purephysician and surgeon, who have ever actedin a spirit of arrogant exclusiveness towardstheir brethren in practice, and with a dispo-sition to promote their own peculiar interests,rather than to study those of the professiongenerally, so that the royal colleges shouldrather be looked upon as medical clubs thanas scientific associations.

It is a well known fact that one of the

greatest ornaments of the College of Surgeonsused annually to boast before a large classof students of his ignorance of medicine; andit is equally notorious that physicians of thehighest rank have professed themselves un-able to use the lancet in cases of the mosturgent necessity ; yet we are given to under-stand that one- of the first measures of medi-cal reform will be to transfer to these par-tially-educated practitioners the whole bodyof general practitioners, the most importantand useful class in the profession, instead offorming the latter into an independent asso-

552

ciation, to which their numbers, talent, andrespectability, would fairly entitle them, andto which the judicious and able managementof the Act of 1815, by a small section of thatbody in the Society of Apothecaries, hasproved them to be fully competent. If it wereproposed to unite the three bodies, and tosubject each individual to a searching exa-mination on the established principles of

every department of medical science, as thefirst step to professional practice of whatkind soever, the case would be different ;but it is only proposed to make the generalpractitioner a degraded appendage to thehigher branches, for the sake of lucre. An-other reform is said to be the removal of allpenalties from the unqualified, thus openingat once the barrier which has been closedfor more than a quarter of a century, andallowing the ignorant pretender to competeon equal terms with the best qualified pro-fessional man : if these hints of the pro-posed reform be correct, it behoves the gene-ral p7-actitioizei- to be on his guard, lestsilence or apathy should be construed intoacquiescence, and the prize which his la-bours have earned should thus fall intothe hands of the royal colleges. I for onewould say,

" If we want change, least of alllet it be such change as they would giveus." I am, Sir, your humble servant,

Urus QUORUM.

July 2, 1842.UNUS QUORUM.

RESTRAINT OF LUNATICS.

A CORRESPONDENT at Lincoln having ob-served an article in a recent number of the

Glasgow Chronicle, levelled at the abolitionof mechanical restraint in the Glasgow RoyalAsylum, by its humane and talented physi-cian, Dr. Hutcheson, with the cordial appro-bation of the directors, as expressed in therecently published annual statement, has

forwarded to us for publication the followingfrank and manly statement of Dr. Hutche-son on the subject :- !

" Restraint.-On this subject I shall saylittle, as it has been already fully discussedin several medical journals. Within the lastthree years, personal restraint in this asylumhaving been very much modified, and almostabolished, since it did not amount to morethan 2 per cent., I endeavoured to do with-out it. On that occasion, in consequence ofcircumstances over which I had no control,the attempt was unsuccessful. During thelast year various obstacles have been re-

moved, my plans better laid, and having theaid of my clinical assistants, I was enabledto abolish it altogether ; and the result,hitherto, has been perfectly satisfactory. The

success of this measure cannot be attributedto an influx of mild cases, or to any other; circumstance than the excellence of the plan.Situated as we are, in a manufacturing and, commercial district, the patients from whichare always more unmanageable than thosefrom agricultural districts ; and having tocontend with the perfer2idnm inbenium Sco-

torum, which is to be matched only in Lan-cashire, as far as I know—with a buildingconstructed on very different views, inconve-nient, and crowded-I have been enabled tocarry out the system completely, withoutincreasing the number of the attendants, andwith the happiest effects. Not only are thepatients quieter and more orderly, butgreat saving of glass, furniture, bedding, &c.,has been effected, the amount of seclusionhas been diminished, and the habits of thepatients have been much improved : nor isthis effected by substitutidg the force ofmen’sarms for that of muffs and belts. Those whorepresent this as the system of non-restraintpursued at Hanwell, Northampton, Lan-caster, and Glasgow, have never given them.selves the trouble to inquire into the subject.Greater attention, forbearance, tact, andkindness are required in the attendants ; butthere is much less struggling and less physi-cal force used than under the old system. Ifit were merely the substitution of the musclesand sinews of impassioned men and women,instead of the cool unimpassioned force ofleather, the system could not be defended ;and if it led to prolonged seclusion or con-finement, to the deterioration of health andthe aggravation of the mental disorder, itwould deserve all the opprobrium which hasbeen cast upon it by its opponents. But thecontrary is the case. There is much lessviolence and struggling, there is less destruc-tion of property, there is infinitely less seclu-sion, and there is greater attention necessa-rily paid to the patients by the attendants,than under the old plan of restraint. Aboveall, as no excessive fury or violence can takeplace without a cause, which may be de-tected and removed, the physician is neces-sarily forced to examine into and remove it.I am, therefore, of opinion, that personalmechanical restraint is in no case necessaryfor the mere treatment of insanity in an asy-lum, and that in all cases it is prejudicial. Ihave tried both plans on a large scale, and Inow express my deliberate opinion, on whichI shall continue to act. The asylum whichis now building is constructed expresslywith this view. It would be injustice not tomention, that to Dr. Conolly of Hanwell,and Dr. Prichard of Northampton, I am in-debted for many hints and contrivances for

carrying out non-restraint."