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Progress Of Psychological Medicine During The Last Forty Years 1841 And 1881

If, gentlemen, History be correctly defined as Philosophy teaching by
examples, I do not know that I could take any subject for my Address
more profitable or fitting than the Progress of Psychological Medicine
during the forty years which, expiring to-day, mark the life of the
Association over which, thanks to your suffrages, I have the honour to
preside this year--an honour greatly enhanced by the special
circumstances under which we assemble, arising out of the meeting in
this metropolis of the International Medical Congress. To it I would
accord a hearty welcome, speaking on behalf of this Association, which
numbers amongst its honorary members so many distinguished alienists,
American and European. Bounded by the limits of our four seas, we are in
danger of overlooking the merits of those who live and work beyond them.
I recall the observation of Arnold of Rugby, that if we were not a very
active people, our disunion from the Continent would make us nearly as
bad as the Chinese. "Foreigners say," he goes on to remark, "that our
insular situation cramps and narrows our minds. And this is not mere
nonsense either. What is wanted is a deep knowledge of, and sympathy
with, the European character and institutions, and then there would be a
hope that we might each impart to the other that in which we are

Do we not owe to France the classic works of Pinel and of
Esquirol--justly styled the Hippocrates of Psychological Medicine--works
whose value time can never destroy; and have not these masters in
Medical Psychology been followed by an array of brilliant names familiar
to us as household words, Georget, Bayle, Ferrus, Foville, Leuret,
Falret, Voisin, Trelat, Parchappe, Morel, Marce, who have passed
away,[293] and by those now living who, either inheriting their name or
worthy of their fame, will be inscribed on the long roll of celebrated
psychologists of which that country can boast.

If Haslam may seem to have stumbled upon General Paralysis, we may well
accord to French alienists the merit of having really discovered the
disorder which, in our department, is the most fascinating, as it has
formed the most prominent object of research, during the last forty

To mention Austria and Germany, is to recall Langermann,
Feuchtersleben, Reil, Friedreich, Jacobi, Zeller, Griesinger, Roller,
and Flemming, who, full of years and honours, has now passed away.

Has not Belgium her Guislain, Holland her Schroeder van der Kolk, and
Italy her Chiaruggi?

And when I pass from Europe to the American continent, many well-known
names arise, at whose head stands the celebrated Dr. Rush. Woodward,
Bell, Brigham, and Howe (whose many-sided labour included the idiot)
will be long remembered, and now, alas! I have to include among the dead
an honoured name, over whom the grave has recently closed. Saintship is
not the exclusive property of the Church. Medicine has also her
calendar. Not a few physicians of the mind have deserved to be
canonized; and to our psychological Hagiology, I would now add the name
of Isaac Ray. With his fellow-workers in the same field, among whom are
men not less honoured, I would venture to express the sympathy of this
Association in the loss they have sustained. Nor can I pass from these
names, although departing from my intention of mentioning only the dead,
without paying a tribute of respect to that remarkable woman, Miss Dix,
who has a claim to the gratitude of mankind for having consecrated the
best years of her varied life to the fearless advocacy of the cause of
the insane, and to whose exertions not a few of the institutions for
their care and treatment in the States owe their origin.

Abroad, psychological journalism has been in advance of ours.

The French alienists established in 1843 their Annales
Medico-Psychologiques (one of whose editors, M. Foville, is with us
to-day), five years before Dr. Winslow issued his Journal, the first
devoted to medical psychology in this country, and ten years before our
own Journal appeared, in 1853.

The Germans and Americans began their Journals in the following
year--1844; the former, the Allgemeine Zeitschrift fuer Psychiatrie,
and the latter the American Journal of Insanity.

I believe that our Association has precedence of any other devoted to
Medical Psychology, and it is an interesting fact that its establishment
led to that of the corresponding Association in France--a society whose
secretary, M. Motet, I am glad to see among my auditors. The Association
of Medical Superintendents of American Institutions for the Insane was
instituted in 1844; that of Germany in 1864, the subject of Psychology
having previously formed a section of a Medical Association.

Returning to our own country, I may observe that when Dr. Hitch, of the
Gloucester Asylum, issued the circular which led to the formation of
this Association in 1841, almost half a century had elapsed since the
epoch (1792) which I may call the renaissance of the humane treatment of
the insane, when the Bicetre in France, and the York Retreat in England,
originated by their example an impulse still unspent, destined in the
course of years to triumph, as we witness to-day. This triumph was
secured, in large measure, by the efforts of two men who, forty years
ago, shortly after the well-known experiment at Lincoln, by the late
Mr. Robert Gardiner Hill, were actively engaged in ameliorating the
condition of the insane. Need I say that I refer to Lord Shaftesbury and
Dr. Conolly? The nobleman and the physician (alike forward to recognize
the services of the pioneers of 1792), each in his own sphere having a
common end in view, and animated by the same spirit, gave an impetus to
the movement, the value and far-reaching extent of which it is almost
impossible to exaggerate. Lord Shaftesbury,[294] celebrating his
eightieth birthday this year, still lives to witness the fruits of his
labours, of which the success of the well-known Acts with which his name
is associated, will form an enduring memorial. Dr. Conolly was in his
prime. He had been two years at Hanwell, and was contending against
great difficulties with the courageous determination which characterized
him. I do not hold the memory of Conolly in respect, merely or
principally because he was the apostle of non-restraint, but because,
although doubtless fallible (and indiscriminate eulogy would defeat its
object), he infused into the treatment of the insane a contagious
earnestness possessing a value far beyond any mere system or dogma. His
real merit, his true glory, is to have leavened the opinions and
stimulated the best energies of many of his contemporaries, to have
stirred their enthusiasm and inflamed their zeal, to have not only
transmitted but to have rendered brighter the torch which he seized from
the hands of his predecessors. He desired to be remembered after his
death by asylum superintendents as one who sincerely wished to place the
insane in better hands than those in which he too generally found them;
and I hold that, whatever may be our views on what we have chosen to
call non-restraint, we may cordially unite in fulfilling his desire.

As the non-restraint system--a term, it must be confessed, which cannot
boast of scientific precision, but is well understood--has been the
leading, and often engrossing, topic of discussion during the period now
under review, I must not omit a brief reference to it. No one will call
in question the statement as an historical fact that the Commissioners
in Lunacy and the medical superintendents of asylums in this country
are, with few exceptions, in favour of non-restraint. Dr. Lauder
Lindsay--for whose death, as well as that of Dr. Sherlock and of Dr.
White Williams, during the last year, the tribute of sorrowful regret
ought, in passing, to be paid--Dr. Lindsay, I say, had only a small
following in Great Britain. In Germany, on the other hand, although
Griesinger looked favourably upon the system, and Westphal has advocated
it, and Brosius has translated Conolly's standard work into German,
there has not been a general conversion, as may be seen by the
discussion which took place in 1879, at meetings of the Psychological
Society in Berlin and Heidelberg. In France, again, although Morel gave
it the sanction of his name, and Magnan has practised it recently, there
has been within the last twelve months a striking proof of
anti-non-restraint opinion among the French physicians, in an
interesting discussion at the Societe Medico-Psychologique. I wish here
only to chronicle the fact, and would urge the necessity of not
confounding honest differences of opinion with differences of humane
feeling. The non-restrainer is within his right when he practises the
system carried to its extremest lengths. He is within his right when he
preaches its advantages to others. But he is not within his right if he
denounces those physicians, equally humane as himself, who differ from
him in opinion and practice. I therefore unite with the observation of
Dr. Ray, by whom, as well as by the majority of his
fellow-psychologists, the non-restraint system as a doctrine was not
accepted, when he wrote thus in 1855, "Here, as well as everywhere else,
the privilege of free and independent inquiry cannot be invaded without
ultimate injury to the cause."[295]

The arguments in favour of mechanical restraint are clearly set forth by
Dr. John Gray, of the Utica Asylum, in his annual report of the present

Leaving this subject let me recall to your recollection that when this
Association was formed, the care of the insane in England and Wales was
regulated by the Gordon-Ashley Act of 1828,[296] which, among other
reforms, had substituted for the authority of five Fellows of the
College of Physicians, who performed their duties in the most sl