I have been reminded that in my first notice, when I spoke of Dr. Davey, Dr. Nesbitt, and Dr. Hitchman, as having respectively introduced the Non-Restraint System into the asylums of Colney Hatch, Northampton, and Derby, it would appear that I overlooked the fact of that system having been adopted at Northampton by Dr. Nesbitt's predecessor, the late Dr. Thomas Prichard. Although my meaning was merely that the three physicians named had each left Hanwell convinced of the practicability and safety of the non-restraint system, and had steadily maintained it on their removal; I ought, perhaps, to have added, that at Northampton it had already been acted upon, and zealously and ably defended in the successive annual reports of the superintending physician. One or two occasional instances of the abandonment of the principle deprived this early and laudable example of full effect.

From the last Report of the Commissioners in Lunacy I have calculated the rates of recovery and mortality in the different county asylums, so as to obtain a mean average for the five years over which their enquiries in Appendix (H) extend. The results may be thought interesting to many readers of the Asylum Journal, who have not leisure or inclination to go through the detail of such matters for themselves.

Most of the well-authenticated instances of long-continued fasting on record are such as have arisen from physical incapacity to take food into the stomach, or to retain it for the support of the system when taken, —from a peculiar condition of the mind, which induces in the individual a disregard or disinclination for food,—or, lastly, from accidental circumstances, as shipwreck, burial in mines, and such like. Those cases which have their origin in either of the two former causes, or in a combination of them, are important to the medical attendant on the insane, inasmuch as they not unfrequently occur in persons under treatment in lunatic asylums, are sources to him of great trouble and anxiety, and are fraught with considerable danger to the life of the patient under his care.

In a recent review of the answers of the medical officers of asylums, published in the Eighth Report of the Commissioners in Lunacy, it is objected that “many of the gentlemen who have forwarded replies to the Commissioners, and who have expressed an unqualified opinion in favor of non-restraint are men of but limited experience, having but for a short time been practically engaged in the treatment of the insane Again, a few of the medical men who answered the circular of the Commissioners, are in the habit of admitting into these houses a limited number of ‘nervous invalids,’ a quiet class of patients, not at all likely to require the application of mechanical restraint in their treatment. The evidence of these gentlemen is not, therefore, of much value quoad the question at issue.'’

It has several times happened to me during the earlier years of my asylum experience, to observe the occurrence of what appeared to be extensive bruises in the persons of feeble and helpless patients, who were in the hands of skilful and attentive nurses, and in whom such occurrences perplexed not less than they shocked me; as I am now distinctly convinced that these appearances were not owing to external injuries, as I can find them nowhere alluded to in books, and as their repetition is calculated to lead to unfounded suspicions, I think a few observations respecting them appropriate for the pages of this Journal