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placing a person in a hospital for the purpose of procuring his recovery, and subjecting him to interdiction. This is clearly shown by the customs of our people ; for of the thousands of persons in our hospitals and asylums, not one in twenty is under guardianship. Had there been any thing essentially wrong in this, it would hardly have been left to this day and generation to discover it. No one, with any practical knowledge of the matter, — of the feelings and motives that govern men when brought face to face with the question of confining an insane friend, can fail to see that this course is quite incompatible with the first two requisites above mentioned. What is implied by interdiction? It implies the taking of property out of the hands of its rightful owner, and giving the control of it to another. It implies the settlement of his affairs, the termination of his business relations, the dissolution of partnership, the resignation of every office of honor or trust, all in a manner more or less prejudicial to his interests, and solely to meet an cxigency that may be of very brief duration. Surely, an attack of insanity is afflictive enough, without any supererogatory misery like this. It would be difficult to give even a plausible reason why a person laboring under a disease of the mind should be treated so differently, in this respect, from one sick with pneumonia or fever. Nobody thinks of placing the latter under guardianship, in order to get him into a fever hospital; and yet he may be confined to his house, and incapable of taking care of himself, for as long a period as the former.
There is another and a very important reason why this measure should be avoided if possible. When the patient comes to himself, and learns that his business, successfully established by many years of industry and enterprise, has been wound up, at considerable sacrifice, as he must know, and that he is unable to dispose of a single dollar of his hard earnings, the intelligence will scarcely help to promote his recovery. It will lead many to think that admission to the hospital has been purchased at too dear a rate ; and, if they have been filled with suspicions and apprehensions, they will find in it confirmation of their belief, and imbibe feelings of hostility that may remain after all other traces of disease have disappeared. And when released from restraint, instead of being welcomed back to his old pursuits and the familiar scenes, and cheered by the fact that his business relations have been maintained at little or no loss, he finds himself obliged to renew the VOL. III.
struggle of life, in new ways and with new associates; and fortunate will he be if the effort prove not too much for a brain rendered morbidly irritable by recent disease. Physicians who have charge of hospitals for the insane are in the habit of advising the postponement of interdiction to the latest moment; and in a public communication the English Commissioners in Lunacy once gave similar advice. “It is hardly necessary to observe," they say, “that proceedings by commission are, generally speaking, advisable only where the insanity is likely to be of a permanent character. . . . Wherever a reasonable hope of recovery exists, and the income of the lunatic can, in the mean time, be properly administered for his benefit, without a commission, the general practice among the friends and relatives of the insane is to avoid resorting to proceedings which entail unnecessary cost, which, by the disclosures they occasion, are most painful to the feelings of the family, and which, by the excitement they produce, are sometimes injurious to the patient himself.”
It is easy to see, in view of such discouragements, what would be done with the patient, or rather what would not be done with him. He certainly would not be sent to a hospital, if by any possibility he could be kept at home, or somewhere else. Every makeshift would be resorted to that friends and neighbors could suggest, every experiment would be tried offering the least prospect of success. Not until all these have had their turn and failed, and the friends have become wearied and worried to the last point of endurance, the patient meanwhile getting more and more difficult to manage, would the hateful measure be submitted to, which is needed for his admission to the hospital, too late, probably, to be benefited by its kindly influences.
It is now well understood that, in most cases, an attack of insanity is most speedily conducted through its various stages towards recovery, within those establishments that have been expressly designed for this purpose; and that the sooner they are resorted to, the better, unless special and exceptional circumstances forbid it. Experience shows that the sooner all connection with domestic associations and familiar scenes is severed, and all intercourse with friends and acquaintances suspended, the sooner the morbid process will be stayed, and the work of restoration begun. Whatever tends to discourage this measure, - to favor its postponement until every other has been tried and has failed, - must
prove prejudicial, both to the patient and his friends. It does not meet the difficulty to say that this reluctance is unreasonable, a mere matter of prejudice, and that if people refuse to comply with the laws they must abide by the consequences. It is not very unreasonable, surely, to wish to avoid a certain positive evil, though at the risk of encountering a greater one that may never happen. It is immaterial whether the measure in question were avoided for the wisest of reasons, or the most senseless of prejudices. We must legislate for men as they are, not as they should be, having reference to their customs, their feelings, as well as their abstract sense of right and of the fitness of things. Laws, the best in the world, theoretically considered, fail to effect their purpose when not in harmony with the ways, manners, usages, and spirit of the people for whom they are made. Believing, therefore, that to make interdiction preliminary to isolation would cause infinitely more mischief than it would prevent, we are obliged to look for some other way less burdened with objections.
In most if not all the States, there is a provision whereby a magistrate, generally of the lowest grade, is authorized to send to some place of custody any insane person going at large and declared to be dangerous, though these conditions are much like those fictions of the law that are not to be literally construed. Although originally intended as a measure of police, applicable to insane vagrants, it is sometimes used to secure the isolation of persons having friends and social position. But there are serious objections to its being employed for this purpose. Having been in use from time immemorial as a police measure, and, consequently, associated with the idea of vagrants and dangerous subjects, the friends, naturally enough, shrink from it; and the patient, if not entirely devoid of reason, conceives that he is treated as a criininal, and is vexed and irritated accordingly. Nevertheless, it has some advantages over the last-mentioned measure. It is prompt in its operation, and affects the person only, and not the property.
People who have little knowledge of insanity, and a great deal of faith in time-honored phrases, have proposed, as a preventive of the abuses incident to isolation, a trial by jury, impanelled especially for the purpose. This method has been actually adopted in Illinois by legislative enactment, under a pressure of popular excitement arising from accidental causes. Except that it leaves the property undisturbed, it is open to all the objections that lie against the measures already considered. It is equally shocking to every notion of domestic propriety, and equally repugnant to that instinctive delicacy which shrinks from exposing the infirmities of those we love. A jury trial is a public affair: the proceedings may be printed in the newspapers, and the griefs of a stricken family become food for heartless gossip. A grosser perversion of this noble institution from its proper ends can scarcely be imagined. Although an admirable contrivance for eliciting truth in disputed transactions between man and man, it is totally unsuitable as a means of obtaining correct results in regard to questions purely scientific. When we are told that in the place where it was adopted, all the patients in a large public hospital — the epileptic and the paralytic, the idiotic and the imbecile, the raving maniac and the poor demented creature not knowing his right hand from his left — were subjected to its operation, it seems more like a phantasmagoric jumble of social and legal proprieties,
"The brood of folly without father bred,”
than the work of the assembled wisdom of a large and intelligent State.
Let us look at it for a moment. The question for the jury to decide, is, whether the person before them is sane or insane. The friends and attendants tell their story, the family physician, and perhaps other experts, give their opinions, and then the jury must agree or disagree upon a verdict. In will or contract cases, where the mental condition of the party is in question, there are always side issues on which a verdict may be made to rest, irrespective entirely of the principal issue. But here the naked question, sanity or insanity, is the only possible avowed issue, and it must be squarely met. If they are sensible men they will be governed by the views of the experts. If, as is more probable, they think that they, as well as doctors, know something about insanity, they will have an opinion of their own, and decide accordingly. Now, in the former instance, it is the experts who really decide the case, and the jury becomes a superfluous appendage to the procedure. In the latter, a question of medical science, involving the happiness of families, and the highest welfare of an individual, is determined by men completely ignorant of the whole subject. In all jury trials, the jury are not allowed to be judges of the law. Are they any more competent to be judges of medicine? If it were a ques