Under this title Dr. James Russell, of the Hamilton Asylum, Ontario, read a paper before the American Medico-Psychological Association, and published it in the Canadian Practitioner for June of this year. He tells us that there is a growing tendency on the American continent to drop the term “asylum” in favour of the less suggestive title “hospital.” In the recently published transactions of that Association it would appear that the designation “hospital” is applied to ninety-three institutions, as against “asylum,” which is only used forty-eight times. In a peroration extending to nearly fourteen closely written pages, Dr. Russell inveighs against the disuse of the term “asylum.” His paper is redundant with digressions, which touch almost every conceivable point in the domain of psychiatry; many of his statements are highly controversial, while his discursive argument is open to destructive criticism both from those who differ from his conclusions and those who, for other reasons, adopt them. It is not, for instance, because we are afraid of “trusting too much to scientific methods,” as opposed to the use of the more general influences of occupation, recreation, and environment, which ordinarily abound in modern establishments for the care of the insane, that we prefer the name “asylum;” nor is it because we agree with Dr. Russell that an asylum hospital is an insignificant portion of the institution—amply large for the treatment of physical disease alone if it accommodate five per cent. of the asylum population—that we reject the general term “hospital.” On the contrary, we feel that we cannot have too much of “scientific method,” and we believe that an asylum of the present day ought to be largely an hospital in which from thirty to forty per cent. of the inmates are actively treated, medically observed, and constantly nursed. It is unnecessary, even if it were for edification, to follow Dr. Russell in his simple but crude classification of the insanities and his extraordinary therapeutic theories. We do not gather by what recondite means, apart from the humble medical appliances at our disposal, he proposes to “recharge the exhausted brain batteries of the melancholic with the electric current of thought,” or “chain and harness the overcharged batteries of the maniac to some mental or physical process.” We are far from agreeing with him when he asserts that because the pathology of systematised delusion has not yet been elucidated, it has therefore no morbid histology, no basis for medical treatment, and that it is merely an exaggeration of a condition which he unwarrantably asserts is only too common in “a world teeming full of paranoiacs everywhere.” Such opinions are not altogether novel. We have heard them more moderately, if not more ably expressed, but never perhaps with such wanton ardour and glorious disregard for contemporary opinion as distinguish their latest exponent.
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