and cure, (concerning all of which the most destructive errors continue to prevail,) I will venture to affirm, that the mortality to be apprehended from their intrinsic severity, need not be contemplated with terror.

The peculiar nature of my experience, perhaps, may be deemed to justify my speaking with some degree of confidence upon this important subject; and it assuredly would not be, upon any evidence short of demonstration, that I should permit myself to assert, in the most unqualified terms, that with the exception of those diseases, as small pox and measles, which notoriously depend upon that source, there is no fever nor any general disease in existence, that we know of, which is propagated by contagion.

I have been led more at large into this train of observation (continues Dr. M) from having repeatedly perused in the public journals advertisements announcing the meeting of a soi disant Institution, for the cure and prevention of contagious fever in the Metropolis;" and by the desire to counteract the false and pernicious impression that might be made upon the public mind, by an annunciation of this nature, seeming to come from medical authority, if it were left freely to operate, in the event of any casual increase of sickness in London, or others of our populous towns or cities.'

The above extract from Dr. Maclean, is a sufficiently unequivocal statement of the inferences which his inquiries have led him, to make on the subject of febrile origin and transmission; and we have been been induced to present such inference in full to our readers, partly because it is in general best to permit authors to speak in their own language, and partly because we are desirous of doing the little that is in our power, to advocate the cause of an institution, which has thus, in our judgement, been unjustly aspersed by the strictures of the present writer.

We have already, in terms that cannot be misunderstood, expressed our accordance in the sentiments of the anti-contagionist, when he maintains the independent origin of fever; in other words, we have repeatedly announced our belief in the frequent production of fever, without the application of the virus of fever; but, having gone along in unison with the oppugner of contagion up to this point, we here stop, and argue the matter with him; and as all argument is groundless that has not fact' for its support, we shall now state a circumstance which we have happened to witness within a few days since. In one of the dark and dirty streets of London, the father of a poor family fell ill of fever, which proved to be of the erysipelatous kind, and which was pronounced not contagious. Previously to this poor man's complete recovery, his wife, who had been his nurse and attendant, likewise fell with fever, which, to use the language of medicine, assumed more of the true typhous character. This, Dr. Maclean and Dr. Adams would tell us, was induced in the wife, by the same causes as VOL. VII. N. S. 2Z

those which occasioned it in the husband, and does not prove any thing in favour of contact with the sick, as the source of the complaint. But very soon one of the children likewise was attacked with fever, which still put on somewhat of a different type from that of both father and mother. During the whole of the time, relations and friends exposed themselves with impunity to the infectious atmosphere of the apartment, and we heard of no individuals but those belonging to the family (sleeping and coming in contact with each other,) being at all injured by exposure. Now, it would appear to us to be a conjecture founded on all the fairness of analogy, and comparison with other cases, that had the poor fellow who was the first to fall under the influence of fever, been immediately removed to the fever house in the neighbourhood, and there nursed and attended upon, none of the other branches of the family would have become the subjects of fever, and that such cases in all instances being thus treated, the multiplication of points of contact would thereby be prevented, and the spread of infection interrupted. From all indeed that we have seen, from all that we are daily in the practice of seeing, from every fact and from every law connected with the pathology of fever, we feel convinced that the separation of the sick from the healthy is an important principle in the management of febrile cases, and in the prevention of febrile propagation.

In the above narration it will have been remarked, that the successive attacks upon the respective individuals, were of a different kind, and this difference we should explain by the comparative mildness of the poison, which, while it was sufficiently operative to occasion disease, was not powerful enough to engender a precisely similar complaint in each instance; and, it is upon this particular our readers will recollect, that we formerly made to hinge the difference between the virus of fever, and that of the true contagions: and it is upon this ground, as it appears to us, that the inexpediency of quarantine may be argued and proved; as it has never yet been found that any individuals ill of fever, or any garments worn by, or having come in contact with, such individuals, are sufficiently poisonous to produce an epidemic disorder in distant lands, of which the latitude and condition of the atmosphere are dissimilar. With Dr. Maclean then, we believe,

1. That the laws of quarantine are absurd.

2. That plague police establishments, are in fact insufficient for their object.

3. That they are injurious to health, navigation, and commerce, and

4. A source of great and pernicious expenditure.'

But we do not believe with him, that fever can never be

communicated by contact, or that its virus is incapable of passing from the living body into inanimate matter, and rendering such matter to a certain extent infectious. It is the comparative, not the absolute want of power of the virus, upon which we would establish our objections to quarantine, fully convinced as we feel, of the actual necessity for the combination of many adventitious causes, in order that an endemic should be conveyed from one region of the globe to another.

But we cannot again go over the ground of the contagious dispute; nor, should we have even adverted to it in any way, had it not been for the increasing interest which has been excited in the public mind on this question, by the recent revival of an almost extinguished malady, Typhus fever. Of the spread and increase of this malady, we for ourselves have no apprehensions, convinced as we are, that the present mode of managing the complaint by separation, cleanliness, ventilation, &c. will prove sufficiently preventive of its becoming endemic in Britain, to any thing like the extent with which it formerly raged; and as to the importation of this, or any other form of fever, we verily believe it to be impossible in the nature of things, for a whole ship's crew landed immediately from the Levant into London, even with the plague upon all of them, to be equal to making the plague endemic with us, unless by the grossest mismanagement we gradually suffered that atmosphere of infection to be formed, upon which so much has been said in the article to which we have previously referred our readers.

With regard to the particular pamphlet under consideration, we have to say generally, that with some exception of awkwardly involved phraseology, it is upon the whole creditable to the Author's talents as a writer. It is, however, of too dogmatic a cast, and is objectionable on the score of its unfounded pretensions to novelty. Dr. Maclean is by no means the first person, as he all along insinuates, who has called in question the existence of contagion, or detected the error and absurdity of quarantine.

Art. VII. 1. Considerations on the Moral Management of Insane Persons. By John Haslam, M.D. late of Pembroke Hall, Cambridge. pp. 80. Price 3s. London. Hunter. 1817.

2. Cursory Remarks on a Bill now in the House of Peers, for regulating of Madhouses, (its probable Influence upon the Physical and Moral Condition of the Insane, and upon the Interests of those concerned in their Care and Management.) With Observations on the Defects of the present System. By George Man Burrows, M.D. F.L.S, &c. pp. 104. Price 4s. Longman. 1817. SOME of our readers will probably be inclined to say, that Insanity, like Infection, is a subject that has been already

exhausted by us. The two pamphlets, however, just announced, are written by persons of accredited authority, and it would seem not to be amiss to give our readers a slight notice of their character and contents. Whatever, indeed, promises to throw light upon either the nature or the management of mental alienation, will still continue to be regarded with no slender interest, and we opened both the pamphlets before us, with that kind of anticipation. which is grounded upon former proofs of

merit.

Something like curiosity too, mingled itself with our desire to peruse the lucubrations of Dr. Haslam, on a topic in which he has lately been implicated in so very extraordinary a manner. Will his tract, thought we, (it was a very natural suggestion,) assume any thing like the shape of a justification of himself, and a condemnation of his accusers?

Dr. Haslam, we do not hesitate to say, has somewhat disappointed us in every particular. He is totally silent on the subject of his own case, and, considering the extensive opportunities which he has had of observing the wanderings of the human mind, and the ability he has displayed in his prior publications, the pamphlet now under notice we are compelled to characterize as a rather meagre production.

To say it is destitute of interest, would be saying too much. We meet, in the first place, with some very just and welltimed remarks under the head of coercion. We call them welltimed remarks, because we are somewhat disposed to think, that from the natural tendency there is in the mind to extremes, that part of the public which takes a particular interest in insanity, will be too much disposed, in the present state of things, to regard with too jealous an eye the exercise of even necessary and salutary restraint in cases of maniacal violence. The following remarks too, as well as being just in themselves, will serve to show the combination of qualities which ought to be possessed by the persons who undertake the direction and control of deranged intellect.

Abundant experience (says Dr. H.) teaches us, that restraint is not only necessary as a protection to the patient and to those about him, but that it also contributes to the cure of insanity. It is not intended here to institute a physiological inquiry into the nature of madness, nor to investigate the history and constitution of its attendant passions: it will be sufficient to demonstrate that habits of self-control are established both in the sane and insane mind by the same agents. That the fear of punishment or degradation which deters a rational being who exercises his reflection, from the commission of a crime, would in due time and properly administered check the outrageous sallies of the lunatic.

The fact is well established, that proper restraint on the conduct of an insane person, will curb his propensity to precipitate his

thoughts into immediate action, although the derangement of his intellect still continues. It should be the endeavour of the practitioners in those cases where malevolence forms a prominent feature, to ascertain how much appears to arise from actual disease, and what part should be attributed to evil passions associated (with), but not actually depending on the morbid affection; and this inquiry will be considerably facilitated by a consideration of the natural character, education, and pursuits of the patient. The necessity of restraint, as a mean of cure, is most satisfactorily illustrated from the confession of those who have recovered, and who possess a recollection of their disordered state. When such persons have been asked to what circumstances they especially attributed their recovery, they have in general deposed, that when they found themselves effectually restrained from fulfilling the dictates of their will, they then became enlightened by a gleam of reflection, and ceased to obey the impulse which prompted them.'

When treating on the especial duty of keepers, Dr. Haşlam likewise introduces some very sensible remarks on the command of temper which is on all accounts absolutely requisite to be possessed by those who, are about the insane. It is on this point that, without the most scrupulous care, errors in the management of lunatics, of a highly mischievous kind, are apt to be committed. It is' says our Author, with insane persons, much as with children, their countenance and manner evince, and often through life, the effects of mild and liberal, or of severe and tyrannical discipline.' Allowing the justice of this remark, (and who will dispute its rectitude?) what an awful responsibility is imposed upon them who take upon themselves the charge of governing the minds of such as are rendered wayward, and unruly, and childish, by the most cruel of all diseases! It depends often upon the nicety of moral management,' whether reason shall be reinstated with all her wonted powers, or whether a confirmed melancholy or complete idiocy shall succeed the violent tempests of mental agitation; just in the same manner as the natural disposition of a child becomes matured in after life into frightful monstrosity, or is in a considerable measure quelled and kept under by parental tutelage.

Dr. Haslam is aware of the necessity for improving the condition of keepers, and inciting them to a more humane and conscientious discharge of their duty, and he proposes to meliorate the present condition of this class of persons, by the establishment of a fund, as a provision for the latter period of their lives, to which during their employment, they should contribute by a weekly or monthly instalment. To this scheme Dr.

Burrows objects, conceiving that it would only have the effect of making keepers more idle and insolent, and less obedient to their employers. Both these writers however agree, and every