Under the above title, Dr. Spitzka, of New York, who recently gained the W. and S. Tuke Prize Essay, publishes an address to the New York Neurological Society, in the April Number of the “Journal of Nervous and Mental Disease,” in which he criticises most severely—many people would say intemperately—the work of American asylum physicians and the policy of the American Association of Superintendents of Asylums. There is much truth, however, in what Dr. Spitzka says, and we think our American brethren would do well to take heed to this and many other indications that a more liberal and open mode of conducting their asylums and managing their Association is required. All who know the history of the American Association know the work it has done, and there are few members of the medical profession interested in the matter who are not acquainted with the spirit of philanthropy and self-sacrifice that has generally characterized the physicians to the hospitals and asylums for the insane in the United States. Much good and honest work has been done, and is being done, too, in the scientific study of mental disease in American asylums. It is, therefore, a pity that they should allow their good to be evil spoken of by those who are not fully acquainted with what they and their institutions have done, through any mere mistake in their general policy as an Association. For example, we have never sympathized with the exclusive and unscientific spirit which shuts out Assistant Medical Officers of Asylums from the privilege of membership; we hold it to be a mistake in policy, a misfortune in practice, and unjustifiable on any ground. Dr. Spitzka's article is also a plea for the appointment of visiting physicians to American asylums who shall enjoy the position and means of studying disease which the Visiting Physicians of Hospitals enjoy. The ability of the article is unquestionable, and its vigour almost excessive, but its personalities and spirit are certainly not becoming in one member of a profession towards other members of the same profession, the aims of many of whom are no doubt as high and their conduct as honest as his own. It is certainly a pity that the mode of American political vituperation and its intemperance of language should be allowed entrance into the literature of the mild and merciful profession of medicine. If Dr. Spitzka's arguments and cause are good, surely, on every principle of true literary art and good taste, his language should be moderate and free from passion. We could point out to him some asylums in his fatherland with very distinguished Visiting Physicians, where all the instruments of neurological research and therapy might be found, yet whose management and the comfort of their patients cannot be compared with most American asylums. To these remarks we shall add a few extracts:—
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