The world is scarcely twelve months older since it was astonished and distressed by the Report of the Scottish Lunacy Commission. Scottish members of parliament were eloquently indignant at its plain spoken exposure, of the penurious and cruel neglect, to which the insane poor of that country were subject; people were grieved and scandalized, that such a state of things could be possible in the present day, and the English press was by no means lenient in its censures upon a public economy, which could degenerate into a system of wide-spread cruelty. It is, however, a wholesome practice in contemplating the failings of others, to permit them to remind us of our own past transgressions, and of our present short-comings. The insane poor of Scotland were treated with barbarous neglect, because the state had omitted to extend to them its protection; and they were consequently provided for on principles of pauper economy, in the manner most consistent with the views of those who dole out the poor rate to its destitute recipients. But a few short years since, the pauper insane of rich and civilized England were equally unprotected by special enactments of parliament. They were maintained out of the poor's rate in the manner which seemed best to the poor-law officers. How this was done is to some extent recorded in the parliamentary enquiries of 1815, and in the early reports of the Commissioners in Lunacy. It was found by dire experience, that the custody of the insane poor could not be entrusted to those who are compelled by law to find the funds for their maintenance. The legislature interfered, and by wise and humane enactments, transferred all custodian power over the pauper insane, from overseers and guardians of the poor, to the county magistracy, to that influential, wide-spread, and educated justiciary, to whom so large a share in the administration of English law and justice is committed. Under these enactments, the English County Asylums have been erected and managed in a manner which has met with the highest approval of the public. The deficient accommodation, however, of these asylums and the rapid increase of pauper lunacy, again brings prominently forward the question of the custodianship of the insane poor. In every part of the country, frequent applications are made, for the discharge of so-called “chronic and harmless lunatics” from county asylums, in order that they may be detained in custody in union houses. The poor-law board returns for last year shew that there are no less than 8,600 insane paupers at present confined in union houses, being more than one-half as many as the pauper inmates of county and borough asylums. For the most part the insane inmates of union houses, are distributed among the sane inmates. Far be it from us to stigmatize the companionship of the insane, as necessarily degrading and painful. Under skilful management it is certain that the habits of many insane persons are as little offensive, and their companionship as unobjectionable, as that of persons in whom the reason holds it throne. But in union houses where skilful management of the insane is impossible, the promiscuous association of pauperism and insanity is every way objectionable. It is a flagrant injustice to those sane persons, whom misfortune has thrown upon the support of the poor's rate, to be compelled to associate by night and day with the dirty and drivelling idiot, with the moping melancholiac, or the chronic madman, who may appear to be harmless and safe, but whom many serious and fatal accidents in union houses and elsewhere, proves to be most untrustworthy under the unhappy circumstances of hunger, neglect and irritation. To the insane pauper, the run of the union house in place of care and treatment in an asylum, is a thorough denial of his rights; rights to which he has a claim, as well-founded as the clergyman has to his tythes, or the landlord to his rent, or the tenant to the usufruct of his land.
THE STATE CIVIL MEDICAL SERVICES: With Special Reference to the Poor Law and the Reorganization of the Home Civil Medical Service