a period of thirty years, which in any way bore on the subject, without any reserve. An idea of the method pursued will be formed from the following quotations: (The letter of Dr. Robertson contains the questions and answers contained in the paper published in the Journal of Mental Science, which is published heretofore by me.)

In this way in addition to these points, I showed the following as the results of my whole whole experience:

1. Though there are no guards of any kind for the windows or fires, except two nursery ones open at the top and simply hooked on, the value of the glass destroyed during the whole of "last year" (1888) was only one shilling, and of clothing of all kinds seven shillings and six pence.

2. The proportion of recoveries calculated on the admissions for the last ten years was 47.3 per cent.

3 The proportion of attendants to patients was one to 15.8. (This is less than in asylums where restraint is somewhat freely used.)

4. That ten patients had suffered from broken bones, but all were simple fractures. No patient sustained permanent injury.

5. There has never been either suicide or homicide. (This still holds true, 2d April, 1892.)

6. That no attendant has been permanently injured. Though two have sustained dislocation of the shoulder, it was easily reduced. These and one or two temporarily stunning blows on the head were by far the most serious occurrences.

It will be evident that I cannot claim to have absolutely abolished mechanical restraint in my practice. Still the fact that it was used only in the form of locked and padded canvas gloves in a few intensely suicidal cases, and that several years sometimes passed without their being once applied, shows a near approach to complete non-restraint.

After detailing my experience as above explained, I invited any of the advocates of the freer use of restraint to record theirs in the same way. No one, however, up to the present time, has chosen to do so. Dr. Yellowlees certainly stated that for a number of years there had been no suicide in the asylum of which he has charge. But this had reference only to one of the many points referred to in my record, and even in regard to it his statement was restricted to a part of his experience. It seems a legitimate conclusion that on all other points, as well as on the remaining part of his experience in the one he adduced, he felt his position to be a weak one; in fact that, with the free use of restraint which he recommends, he was unable to submit so favorable statistics as I have done with all but complete non-restraint.

Possibly some of my American confrères who favor restraint may accept my friendly challenge. Should any one submit a better record than I have published, those who, like myself, adhere, or rather all but adhere, to the methods of Tuke and Connolly, may then reconsider their position. Meanwhile, even our opponents on this question must be constrained to admit that if the results of non-restraint are only equal to those of restraint the palm rests with the former. A fortiori if it is clear that the results on all points are much more satisfactory, then surely there is strong argument against the harsh and forbidding methods of restraint.

In June, 1883, Dr. ALICE BENNETT, then, as now, medical superintendent of the State hospital for the insane at Norristown, Pa., was requested by me to read a paper before the Medico-Legal Society of New York, upon the subject of "Mechanical Restraint in the Treatment of the Insane."

She had for a few years at that time introduced the doctrine of a total abolition of the use of mechanical restraint, and was one of the pioneers in the early movement in American asylums, some ten years ago, to make an earnest effort to see if it could be wholly dispensed with and still leave the condition of the inmates improved-a proposition that so few superintendents in the United States believed possible.

Her paper was read, and was published in the first volume of this journal, and, from my standpoint, exercised an enormous influence among superintendents of asylums, in inducing others to make the effort.

The asylum had a large population, drawn from all classes, and the effort which was then successful demonstrated that at least this institution had progressed and prospered without any recourse to mechanical restraint at all.

I can but feel that in this discussion some extracts from that paper will be felt by all earnest inquirers after the truth, in its application to the practicle side of the question, to be valuable, timely, and deeply interesting. The whole paper is entitled, perhaps, to be included, but the scope of the article limits me to a few extracts. Dr. Bennett says:

I will ask leave to pass over the history of former discussions on this subject, interesting though they be, and speak to you only out of my own experience of what I have seen and known.

In a service of three years (lacking one month) in the State Hospital for the Insane of the Southeastern District of Pennsylvania, something over eight hundred female patients have been under observation. This experience, while confessedly short and inadequate, is yet believed to cover the usual variety of phases of insanity, and more than the usual proportion of the chronic, turbulent class so often the subjects of mechanical restraint. From the county alms-houses, where cases had been ac

cumulating during the years when this District of Pennsylvania had no adequate provision for her insane, came a cousiderable number who had been habitually, for months-some even for years-subjected to some form of mechanical restraint. With a new and untried organization, inexperienced officers and subordinates—with the general barrenness incident to a new hospital, and the almost total absence of the usual devices for attracting, diverting, and occupying the large numbers that were literally poured into the hospital from all sides, it is believed that the conditions have been such as to offer a test more than ordinarily severe. During the first fifteen months some little restraint was used experimentally. Since October, 1881, none has been employed. The results of the first three months' experience were given in the first official report of the Department for Women to the Board of Trustees, as follows: "Nothing is more certain than that mechanical restraint is incompatible with 'moral treatment,' aud that resort to it destroys at once any personal influence that may be brought to bear. Whether a confession of fear on the part of the attendant, or a substitute for the latter's vigilance, it can hardly fail to lessen the bond of respect between patient and attendant, which it is essential to preserve."

And, again, a year later: "Extraordinary precautions often suggest or increase the 'violence' they are intended to prevent. Freedom of action is a wonderful tranquilizer. When to these restless, rebellious natures leather bands and canvas jackets say 'you shall not,' the antagonistic spirit responds at once to the stimulus. The impulse to do the thing forbidden is likely to disappear with the removal of the apparatus which suggested it, and if judicious moral influences are brought to bear, will not return in any uncontrollable form."

Briefly formulated, my convictions, based upon experience, are as follows:

1. Mechanical restraint does not, (in the majority of cases,) "restrain." [It is not easy, by any mechanical appliance, to so confine a person that he cannot accomplish something by muscular effort, and energy, checked in one direction, finds some other outlet, with the added impetus of resentment and desire for revenge.]

2. It does exert a positive influence for evil.

3. It is infinitely easier, safer, and cheaper to do without it.

From every point of view, then, in the interests of the insane themselves, in the interests of their keepers, and in the interests of public economy and of humanity at large, mechanical restraint should be abolished.

But we are again told authoritatively: "These principles have been settled; mechanical restraint is inadmissible in itself; it is to be used only when necessary and indispensible for exceptional cases."

Just what these "exceptional" cases are is not laid down; I have not seen them, and I need not tell you that this rule of necessity is apt to become a sliding-scale, adjusting itself to the convenience or caprice of the hour until the "exceptional" cases are likely to cease to be exceptional. Even admitting, (which I am far from doing,) the existence of the hypothetical, occasional case which may be benefited by restraint, I would

still hold fast to the principle of the " greatest good to the greatest number," and would unequivocally banish an agent which so certainly becomes a centre of evil influence.

And again:

You will agree that it is a not uncommon trait of our common human nature to want what is beyond our reach-to desire to do the thing forbidden. Especially is this true where the higher control of reason and of will is undeveloped, as in children, or in abeyance, as in the insane, who frequently are only "children of a larger growth."

Trust begets trust-worthiness; and the reverse is no less true.

Now if a person, (more or less insane, as the case may be,) sees every provision made for his conducting himself like a wild beast, I do not doubt that, in nine cases out of ten, he will proceed to justify that expectation. If, in addition to windows barred, screened, and locked, double doors, (perhaps even with the small sliding windows so suggestive,) heavy immovable furniture—surroundings calculated to arouse an antagonistic spirit-he is perhaps seized upon, and either because of what he has done, or of what some one fears he may do, his personal liberty is stiil further abridged by some of the many ingenious forms of mechanical restraint, what wonder that his evil passions rise and that he proceeds to do all the damage possible, and I assure you he can do a great deal; if his hands are confined he can kick, if his feet, he can bite, and both with a forocity and accuracy of aim most undesirable.

You can easily see how such a case goes on from bad to worse. The restraint continues to excite and intensify the "violence," which, progressively increasing, becomes each day a stronger "justification" of the restraint, and so have been manufactured those notoriously desperate cases which are pointed out to curious visitors as having been "chained” or "caged" for years. Examples of these are, happily, less common than formerly, but the county alms-houses still furnish a few, and one such has come under my care even during the past year.

One who has watched the transformation of cases like these under the influence of personal liberty and rational methods of treatment can but marvel that a principle so plain, so evidently founded in the commonest laws of our common nature, should admit of discussion.

In support of the statement that it is easier and safer to control the insane by moral than by mechanical means, perhaps I cannot do better than to give you notes of some individual cases that have occurred in my experience:

Case I was introduced to us as a most dangerous character, especially renowned as a "kicker;" had been continuously restrained in another hospital by a leather "muff" for six months preceding admission. The propensity to kick everything and everybody within reach being a natural consequence of the confinement of her hands, it followed that the simple removal of the "muff" made her at once a less dangerous companion. By systematic, firm, yet kind, discipline, bad habits were corrected, self-respect stimulated, and she has become a tractable, working patient, although belonging to the hopelessly chronic class.

Case 2, an immensely powerful, muscular German woman, one of the first admissions to the hospital, brought with her a reputation for ferocity calculated to strike terror to the soul of the uninitiated. For months she had been chained in a dungeon, the limited space of which scarcely permitted her to lie at full length on her heap of straw. Through the grating of the heavy door was thrust the food, which she must eat as best she could, with hands confined. Here, also, the curious were privileged to gaze upon this monster in human form, who, with her hair long ago torn out by her own hands, and her expression of savage distrust and defiance, might well seem something less than human. A year ago I introduced a gentleman interested in public charities to this same woman, standing in the door of her neat little room, which she invited us to enter and inspect. Her thick gray curls surrounded a face strongly-marked and resolute, yet not unpleasant to look upon, and her general appearance was such as to attract a stranger at once.

She was led to speak of her former experience, "And why were you locked up in a dungeon?" asked my friend. "Because but I can not repeat her language. At the mere recollection, a tithe of her old fury was aroused, and her mein hinted at the total annihilation of anybody in

her path.

"But why did you have those feelings there and not here?" persisted the visitor.

"Because they locked me up. Would you like to be locked up like a beast?" came the answer, with an emphasis which was a whole sermon in itself. This patient also belongs to the chronic class, and is probably a "life-member " of our little community, but she is a busy worker, she has a quick, ready intelligence and warm affections, and her life is not altogether an unhappy one.

Case 3, on admission, had worn the camisole for a length of time. The proficiency this woman had attained with her feet was marvellous. To open and shut windows and make, (but more often to unmake,) beds was easy and her mischievous propensities knew no bounds. This case is a good example of the inefficiency of restraint. She has now largely recovered from her mischievous and destructive tendencies, but she, also, is a chronic, incurable case.

Case 4, a young girl of prepossessing appearance, transferred from a county almshouse, had been restrained, as to her hands, for several months previous to admission. "Too violent for women to manage," was the verdict of the man who had had exclusive charge of her during that time. Of this patient I have nothing to say, except that, from the time wristlets were removed, while she lived, (she died of phthisis two years later,) no reason appeared for such restraint. Hopelessly demented, she was yet tractable, grateful for kindness, and kissed the hands of the nurse who liberated her.

Less than a year ago a fire occurred in a county almshouse in the interior of Pennsylvania, and eighteen female patients were transferred to the hospital at Norristown. Of these eighteen, ten came in camisoles, not put on for temporary convenience only, as was testified by their