TO THE EDITOR OF THE ARGUS.
Sir,-On the 4th January you kindly inserted my communication on the above subject in your valuable journal, and various correspondents very fairly criticised the same, and some very generously offered their assistance. I have taken a note of every suggestion; moreover, I have written to gentlemen in America, and have got very valuable information from American merchants in Melbourne. I have also written to Drs. Peddie, Christison, and Skae, of Edinburgh, to whom I am indebted for information of a practical character. It is my intention, with your permission, to enlighten the general public on this all-important subject, and to demonstrate that there is no greater danger of abuse in legislating on this subject than in that of lunacy. In fact, that there is less danger, provided that the medical view he allowed to direct the attempt at legislation.
It is absolutely necessary that the general public be thoroughly informed on the matter, and that they should be fully satisfied that it is not the substance but the name of liberty that is concerned; in fact, that true liberty demands merciful and timely interference. Until this is done, and certain prejudices removed, no beneficial legislation can take place.
It will be very easy to prove that curative treatment is consistent with the most scrupulous attention to true liberty. We have the highest authority for stating that there is no slavery so great as that of those who are under the tyranny of their passions, especially of the most degrading and enslaving of the passions, namely, drunkenness, and its companion immodesty. I wish my readers to weigh well what I mean by the medical view and by the legal view, for upon that the whole question depends. I may here state, that I am not at all speaking of the ordinary drunkard—I am speaking of the insane drunkard.
The medical view is, that the patient is suffering from repeated attacks of insanity, which insanity is sometimes the cause, at other times the consequence, of drunkenness, and in either case that the vital and most urgent consideration is, the patient's safety and recovery, and that at, the earliest possible moment, and that delays are dangerous, inasmuch as by delay the cure becomes more difficult, and the patient disappears. The legal view is caution. See that the patient's liberty is not invaded ; see that he have no cause of action against those who interfere in his favour. Seek out precedents from the sixteenth century ; examine the common and statute law ; make out a case for the law officers of the Crown ; see that his relations are not influenced by improper motives ; some medical certificates cannot be relied on; an Englishman's castle, &c. In fine, as long as there is the slightest possibility of abuse, let the patient alone; the coroner's jury will set all right, whether the patient is guilty of suicide or homicide ; no account is taken of the man's wife, his children, or his property. No, a man can do what he likes with his property or his chattels ; the public may be compelled to support his family in gaol or in an asylum, or suffer in various ways from the scandal of his life and the extravagance of his conduct; no matter, the man dies, probably is damned, but the law is not broken. Now, I ask my readers whether it is the medical view that should lead and prevail or the legal?—the first gives a chance of saving everything, the last of losing everything.
If you wish to save a man from drowning you need not and ought not to be too nice about the means—save him, that is the point. Let no legal difficulties or niceties, or want of precedents, or anything else, stand in the way of the supreme law of charity. Let no legal scruples put an obstacle to the realisation of a simple scheme ; the nearer this scheme approaches the lunacy laws the better. A small committee of medical men could in a few days prepare all essentials for legal finish by a short simple bill, or by a few clauses added to the Lunacy Act. In fact, by the 15th Vict., No. 10, Sec. 14, the Supreme Court in its equitable jurisdiction can do almost all that is wanted, as it has in these cases the same power as the Lord Chancellor of England ; but this is anticipating my argument.
It is quite clear to me that popular opposition to this scheme can only arise from one source of error, namely, from misunderstanding what is meant by the term insane drunkard. I shall now proceed to call attention, to the various species of drunkard, in order to clearly distinguish the drunkard who has lost all self-control. In my former letter I gave a vivid description, from Dr.Hutchison, of the Glasgow Royal Lunatic Asylum. I shall, according to the rule which I invariably follow in my communications, namely, avoid stating anything about which I have the slightest doubt when speaking as to matters of fact; hence I here prefer giving the opinions of those having the best and the most extensive experience ; and among such I rank Dr. Skae, of the Edinburgh Lunatic Asylum. I need scarcely say that my own limited experience, extending over twenty years in general practice, coincides in every respect with that of Dr. Skae.
There is the drunkard who gets drunk at the festive board, or who gets drunk every day after dinner, or every night before going to bed, or who takes a few days' drinking at a time, or who drinks enormous quantities of stimulants and still has a certain amount of control, and can drive a good bargain and attend to his business—he is the decorous drunkard. Some drunkards become very dangerous, especially those who have received any injury to their heads, and of course are accountable for their violence. As long as the drunkard has self-control, and has a method in his madness, and can regulate it as to time, mode, and extent, and can have regard to decency, the duties of life, or the calls of business, he is a mere drunkard, he is not yet an insane drunkard, but is tending to that state, and will ultimately become an insane drunkard if death do not prevent him. Now as to the insane drunkard, he is labouring under moral insanity. These persons do not drink for the sake of the company, nor for the pleasure which the wine gives them; they drink as often as they can, whenever they can, and as much as they can. If they cannot get intoxicating liquors they will drink lavender water, creosote, vinegar, vitriol, tobacco; their craving for stimulants is incontrollable—no regard for self-respect, for public opinion, or common decency, or domestic ties or religion, or impending ruin or degradation, or fear of death, or sight of hell will prevent them from drinking till they can drink no more. Some with tears in their eyes deplore their state, but they cannot help it, and if they cannot help it they are insane, and ought to be restrained. Dr. Skae justly remarks that every form of madness, from acute mania down to dementia, may exist without delusions. It is here that the legal authorities are in error, and commit such fatal mistakes, and prevent medical men from coming to the rescue. There is frequently in moral insanity such a morbid exaltation of the emotions and passions without any delusion that self control is entirely lost; this morbid excitement becomes perfectly irresistible, and not only common decency but the very instincts of humanity are outraged. There is one symptom quite familiar to every medical man, and that is the total disregard of truth in these persons, their ingenuity in deceit is wonderful—they will faint, have toothache or tic, or cramp in the stomach or colic, or diarrhoea, or hæmorrhage, and be on the verge of dissolution, unless brandy, wine or opium is given. They will pawn dress, furniture or jewellery, they will borrow, they smuggle spirits in every possible way, they tell the most deliberate falsehoods and solemnly appeal to God for their truth ; they solemnly deny their habit of intemperance, they have a propensity for theft or fomenting quarrels, some are remarkable for their perverse disposition and temper or for their eccentricity, and many inherit those dispositions. There is a large proportion of such persons remarkable through life for their stupidity or obstinacy, or some special want or mental defect, and not a few of such may he found in haunts of crime and debauchery, and the victims of the evil disposed.
From what I have stated in this and my former communication, I think I have established the fact that there is a fearful evil in the midst of us, to which no remedy has been applied, but, on the contrary, that recent legislation has tended directly to vastly augment the evil. The temptation to drunkenness has within the last year greatly increased ; and I have the authority of one of our police magistrates for stating that crime has increased thirty per cent, since the late liquor law passed. We have drunkenness and prostitution more barefaced, impudent, and public in Melbourne than in any city in the British dominions. We have a fearful amount of sudden deaths from disease of the heart, drunkenness, and suicides. We have not here those social checks that operate so effectually at home. Here it appears that, among our other experiments, it is allowed to try how far the evil propensities of human nature can go in their unchecked career, and that both church and state give up in despair. Now, my thirteen years' experience in Melbourne plainly proves to me that nothing has been done during that time to stem the evil. And, with the blessing of God, and the assistance of good men, I will make the attempt. My first object to save those who are in such a deplorable state as to deserve the name of insane drunkards. My second object is to prevent the swelling up of the ranks of insane drunkards, by correcting the abuse of the sale of intoxicating drinks: by encouraging those publicans who conduct their business respectably, and there are many such ; and by forbidding publicans keeping their houses open at late hours, and absolutely preventing dancing in licensed houses. As long as music and dancing are permitted in public houses, brothels will flourish. Let me not be told that I cannot make people virtuous by act of Parliament—that laws will not stop vice or crime, and that drunkenness and prostitution will continue, laws notwithstanding my answer is, that there never was a law that could totally prevent any crime, and that if there were any force in that objection it would be that there was no use in making laws to forbid murder, theft, treason, or any other crime, inasmuch as these crimes are still committed. The same observation would apply to the Decalogue, and to the whole Bible. My deliberate and long-formed opinion is, that our magistrates could and ought to do more than they do to punish and discourage vice and crime; but I know well that there is one great obstacle in their way, and that is, that prisoners are too well treated in our gaols : this takes away the terror from the sentence. I have often seen prisoners appear pleased when sentenced to imprisonment. Laws in England last year were quite powerless in checking garotting till the cat-o'-nine-tails were applied, and this had immediate effect. Theory is useful, but practice is better. As long us our gaols are comfortable, imprisonment is a farce. It is also a farce to punish prostitutes and not punish their visitors. It is humiliating to see these male blackguards in the witness-box in our police courts prosecuting, when they ought to hang their heads in shame. While on this subject, I may state that the slightest reliance cannot be placed on the oath of an insane drunkard, and that medical men and others are liable to the most grievous accusations by these persons. Lately, I was called to see a woman who made a grievous charge against a medical man. She appeared to be in great agony and dangerously ill, but on my taking a bottle of brandy from between her legs all the symptoms disappeared: the accusation also ceased.
From the above it is evident that I do not intend directly to interfere with the ordinary mere drunkard, or the vicious drunkard, or with the publican who conducts his business respectably. I know that many publican, and especially their wives, are as anxious as I am to do away with late hours, and to get drunkards away from their houses. These people would be very glad if a notice were exhibited in their houses that every inmate found in the house after a certain hour (lodgers excepted) would be fined. Publicans and their families require rest as well as other people.
The first suggestion I offer is the formation of a Lunacy Board, to consist, say, of medical men, barristers, police magistrates, and clergymen; this board to have somewhat of the same authority as the English commission. Of course, an appeal to be from them to the Governor or Supreme Court. The second is to modify the medical certificate so as to include insane drunkards, and not to require in their regard a certificate of insanity. Third, to establish two or three retreats in different parts of the colony, to which patients can be sent voluntarily or by their friends, with two medical certificates ; in every case the board to be informed of the case in three days, The English act says twenty-four hours, This I call a simple order, authorising the detention of the individual for, say a fort-night; the commission then, or their representative, to decide for a longer period after personal observation; the severest penalties, as in the English act, against the medical superintendent if he conceal anything, or neglect to keep his books according to law; the patients to have the fullest liberty as to correspondence; the superintendent to have a certain amount of liberty us to allowing patients out to test their power of self-control ; also to allow the fullest liberty as to the transaction of business, but under the strictest scrutiny as to smuggling of spirits; where there are no friends to allow strangers to move in the matter, provided they satisfy the commission and the sheriff and pay expenses; in certain cases the commissioner of police to move in the matter. In speaking of expenses, I am quite certain that the colony would gain by anticipating the destruction of private property, and the vast expense on orphan asylums, reformatories, gaols, police and law courts. In these cases the friends could so arrange as to authorise the family medical attendant to meet occasionally in consultation the medical superintendent. Dr. Skae says that during twelve years that he was superintendent of Edinburgh Lunatic Asylum he transmitted innumerable petitions from such patients on the ground of wrongous detention to the sheriffs, the lord advocate, and the Secretary of State, and in no instance did the authorities order the release of such patients, on the ground that they were improperly or illegally detained in the asylum, or until Dr. Skae considered the patient entitled to a trial. The Lunacy Commissioners of Scotland say that it is not advisable to administer the law of lunacy as stringently as if it formed part of the criminal code. Hence, in the new Scotch Lunacy Act, an emergency clause was inserted, at the instance of Dr. Christison, in cases where it was dangerous to wait for the sheriff s warrant. One circumstance should never be forgotten, and that is, the large proportion of cures when taken early, and the difficulty of cure when delayed ; hence the more the impediments to removal to an hospital are multiplied the less chance is there for the patient's recovery. I repeat, that the great danger is in unnecessarily multiplying protections and difficulties, instead of giving facilities for the speedy cure of the malady, When a medical man is called to see an insane drunkard, the first question which the friends will ask is, What is to he done? As Dr. Gairdner justly remarks, the law ought not to complicate and embarrass his action by metaphysical and legal subtleties. There is less danger of the liberty of the subject being improperly interfered with in these cases than in other kinds of insanity, inasmuch as the patient under restraint, and deprived of the cause of his mischief, and having full liberty of correspondence, has the power of demanding justice, which the other has not; in fact, the danger lies the other way, in having too much liberty, which he may use in threatening to disinherit his family and quarrel with his family medical attendant unless speedy means were taken to liberate him. As to the certificate of two medical men, surely if they can be trusted in lunacy they can be trusted here. Moreover, the lunacy commission, and the regular inspection, and the liberty of correspondence, render abuse for one week impossible. In a retreat, of this kind it is of importance to the patient in case of a will, or contracts of different kinds, that he has not been certified as lunatic, but only a fit patient for a retreat —the great point is that care is impossible as long as the patient remains in his house and has stimulants within his reach. As to the formation of the Lunacy Commission, and the parties who initiate proceedings and pay expenses, these are matters of detail.
Private retreats would not meet the case, as no authority exists for detaining persons against their will. In England, the Commissioners now called Masters in Lunacy, consist of three physicians and three barristers. They are sworn to act " faithfully, discreetly, and impartially, and to keep secret their in formation." They got £1,500 a year each and travelling expenses, but must not have private practice, and may get pensions. I trust that some member of Parliament will take up this question, and confer a greater benefit on this colony than has been conferred by the majority of enactments that have engaged attention. Some valuable hints have been given by correspondents as to inspecting liquors, and public houses, and lodging-houses, and other matters; these details are valuable. I also approve of the idea of an association suggested. A correspondent suggests to leave the decision of the number of public-houses to the inhabitants of the particular street ; this is the law in some parts of America. As this letter is already too long, I must conclude by thanking those correspondents who generously offered their assistance. I shall be most happy to act with such gentlemen—not as leader, but as assistant—in the holy work. Thanking you. Mr. Editor, for the large space you granted for my former communication,
I am, Sir, yours truly,
CHARLES M'CARTHY, M.D.
1866., March 23, Melbourne,
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