ment of the insane, in private than in public asylums: a system which meets all the difficulties arising out of the condition of the most highly endowed creature in the universe when deprived of guiding reason, and when, in proportion to his higher faculties and gifts, he has fallen from being either in reason noble, or in faculty infinite, to a condition in which he is merely the most mischievous, and dangerous, and miserable of animals. In the illustrative cases already given, the applicability of this system, which excludes all forms of mechanical coercion, has, I think, been shown in relation to every form of mental imbecility, derangement, depression, and decay. The general results are open to all observation in all our larger asylums; the increased individual comfort, the diminution of individual suffering, and the banishment of all the most repulsive features of institutions set apart for the reception of human beings disqualified for ordinary life, but now placed amidst circumstances promotive in the utmost degree of their comfort, and, in proportion to the possibilities in each case, of mental amendment and recovery."

GENERAL SUMMARY OF PROGRESS.-Upon the whole, however, in this country, there is nothing left of the old system calculated to discourage the expectation, not only that the manner of treating insane persons without ever having recourse to restraints will soon be so far understood and appreciated as to be almost universally adopted, but that the old deceptions and abuses in private asylums and private houses must soon exist no more.

"The accomplishments and general character of the candidates for appointments in our county asylums; the admirable reports issuing every year from those institutions, recording every variety of improvement and progress; the clinical instruction already given in some of them; the generous desire evinced by the majority of the county magistrates to make proper provision for the insane poor; together with the continual and even minute attention given by the Commissioners in Lunacy to all that passes in both public and private asylums, are among the circumstances justifying very sanguine hopes of the conservation and extension of all good principles of asylum management. Frequent and liberal discussion of the various subjects connected with lunacy and with asylums has also lately been productive of benefits which will go on increasing. "The varied contents of the Psychological Journal' established by Dr. Forbes Winslow, and conducted with great talent and energy, have attracted the attention of many general as well as professional readers to considerations more or less connected with the welfare of the insane. Still more recently, the formation of an association of the medical officers of asylums has been an indication of their sincere wish to profit by the experience of each other, and to unite in advancing an elevated branch of pathology and therapeutics; for which the establishment of "The Asylum Journal,' now so ably edited by Dr. Bucknill, affords every facility, by the diffusion of information, interesting and instructive to all readers whose duties, whether medical, or magisterial, or general, have any relation to insane persons. The general character of our public asylums, conducted chiefly by members of that association, is already

honorable to us as a nation; furnishes an example which is a globe of precepts;' justifying the expectation that no false economy and no delusive theories will ever lead to the abandonment of the non-restraint system, which comprehends and binds together all the details of sound principle and humane practice. The system, as now established, will form no unimportant chapter in the history of medicine in relation to disorders of the mind. It has been carried into practical effect in an intellectual and practical age, unostentatiously, gradually, and carefully; and is, I trust, destined to endure as long as science continues to be pursued with a love of truth and a regard for the welfare of man. No longer residing in the Hanwell Asylum, and no longer superintending it, or even visiting it, I continue to live within view of the building, and its familiar trees and grounds. The sound of the bell that announces the hour of the patients' dinner still gives me pleasure, because I know that it summons the poorest creature there to a comfortable, well-prepared, and sufficient meal; and the tones of the chapel bell, coming across the narrow valley of the Brent, still remind me, morning and evening, of the well-remembered and mingled congregation of the afflicted, and who are then assembling, humble yet hopeful, and not forgotten, and not spiritually deserted.

"The contemplation of the vast exterior of the wings of the asylum still deepens the happy impression, that through all that extent of ward and gallery, kindness and watchfulness ever reign. And when my thoughts are transferred from this, my home asylum, with its thousand patients, to nearly forty large public institutions for the insane in this great country, in which are more than 13,000 patients, to whom similar comforts are afforded, and throughout which the same system prevails, I find a reward for any share I have had in promoting these things, beyond my deserving; a consolation in years of comparative inactivity, and a happiness far overbalancing the pains and troubles incidental to my life as to that of all mortal men."

ANNUAL SESSION OF THE EAST TENNESSEE MEDICAL SOCIETY, HELD IN KNOXVILLE, OCTOBER 19, 1858.

[THE subjoined report was not received soon enough for insertion under its proper head. We trust, however, that the interest attached to some of the proceedings recorded will excuse our altering our usual order to make room for it.-ED.]

This Society, which embraces the district known as East Tennessee, and which is composed of a membership of about seventy physicians, held its annual session on the 19th ult.

Sevier, delivered the annual Profession of Medicine."

He

The President, Dr. R. H. Hodsden address, "On the Advancement of the established the position by viewing the progress which medicine has made from two points: first, relating to the increased importance attached to medical education, both by those who practice it and by the community; and, second, as a consequence, in the greater certainty in medical practice.

Upon the first point, he alluded to the agitation of the vexed question of reform in medical education as a question calculated to do good by its agitation, even should the schools refuse to agree upon any definite system; that it was settled by the profession at large that there should be an extension of the terms of tuition, and that sooner or later they (the schools) would be compelled to adopt it, as only those schools would be patronized where not only the greatest facilities were afforded, but where the greatest amount of instruction was imparted: not that kind, however, which consisted in cramming the pupil in an inconceivably short space of time, but where the term was extended, and in which greater requirements were made of the pupil. He alluded also to the growing importance of Southern schools, and rejoiced that the metropolis of the State now occupied, with her two schools, the most prominent position in the South and West for imparting medical instruction. These two schools, he said, are deserving of the support of the profession throughout the South; for whilst their Faculties are composed of the ablest men in the profession, the facilities afforded to the pupils in the demonstrative branches and in clinical hing, combined with the accessibility of the schools and the conative cheapness of living, render them the schools of the South. In the one, which has been established for years, is found all that the young man can desire to facilitate him in his studies; whilst in the other, abounding equally in facilities with its associate, is found the additional advantage of a hospital under the same

roof, constituting the first bona fide clinical school for medical instruction established in the South.

The accessibility of these Nashville schools will draw to them, in addition to their able Faculties and equal advantages, large crowds of students. From no point of the South or West will the cost of travel to Nashville exceed twenty dollars, while to Philadelphia or New York it would amount to at least seventy-five dollars, leaving a difference in favor of the Nashville schools of almost enough to defray the expense of boarding during the entire winter. And then, again, it should be remembered that these institutions are located in our midst, and that their professors are practically acquainted with the peculiar diseases of the South. Surely our Southern students will not hesitate to patronize them in preference to the Northern schools.

Another advantage possessed by Nashville over other places in the South is its healthfulness. Although in after life it will be the object of young physicians to contend with disease in all its protean forms, yet while students they naturally prefer a situation where they can pursue their studies undisturbed by the ravages of yellow fever, or small-pox, or cholera; for at this time, without intending it as a disparagement to the schools of Savannah, Charleston, or New Orleans, what student from the up-country would like to hazard his life by resorting to the schools in either of these cities? and is it not now the time for the opening of such schools? For this reason, Nashville will always enjoy the advantage over every other Southern school: in fact, she is to be the rallyingpoint for our medical students from the entire South and West, especially now, since the organization of the new school.

The multiplicity of schools makes it now inexcusable in any one who neglects to attend upon them and derive the benefits which they possess. Consequently, we find our physicians are now better prepared to combat disease, and more successful in its treatment. There is greater confidence manifested in the profession, and an increased disposition to discountenance quacks and quackery in all its forms.

Let us see to it

As a Society, gentlemen, much devolves upon us. that we so discharge our duties as physicians and as citizens, that the title by which we are designated shall suffer no tarnish by being connected with our names.

The first business in order being the election of officers for the ensuing year, it resulted as follows:

DR. O. F. HILL, President.

JOHN L. ATLEE, First Vice-President.

66 C. W. CROZIER, Second Vice-President.

JOHN M. BOYD, Recording Secretary.

RICHARD O. CURREY, Corresponding Secretary.

66 JAMES RODGERS, Treasurer.

Prof. Richard O. Currey was elected to deliver the semi-annual address.

The report of committees being called for,

Dr. R. Peters gave an account of a very interesting case which had

come under his observation, and in fact was at this time under treatment. On January 1, of the present year, a lad of seven years was sucking the air through the metallic thimble, such as is placed at the extremity of the ribs of an umbrella, and such was the force of inhalation that it was drawn through the trachea into the right bronchus. A violent attack of coughing ensued, which, however, subsided, and was only excited on taking active exercise. After a short time, however, the health of the lad began to decline, and he was by the family physician at one time treated for an affection of the brain, and at another by himself for irritation of the bowels, these organs apparently suffering with the affected lung. But during the entire summer he attended school, having, however, a settled cough, which became severe during any fast walking or running. He had also begun to expectorate very freely. On the 29th of August, Dr. P. was called to see the child, and on examination found that, with the exception of a small portion of the lower lobe, there was no respiration whatever in the right lung. It had in fact collapsed, as that side was considerably depressed. There was a constant expectoration of a very offensive purulent matter. The child was very much emaciated, being reduced from a hale boy to a mere skeleton. Combining a sustaining treatment with mild expectorants, he continued to watch the case from day to day. During his early attendance, he was told of the cir cumstance of the lad having swallowed the thimble; but as it was his own statement, his parents did not place much confidence in it, and as Dr. P. did not distinguish any foreign substance, loose or rattling in the bronchia, he was at a loss in believing it; yet there were all the symptoms and results growing out of a foreign body. However, on the 30th September, the whole mystery was solved. In a severe fit of coughing, the thimble was forcibly expelled from the lung. [Here Dr. P. exhibited the article. It is made of lead, is three-fourths of an inch in length, and weighs thirty-four grains. It had remained in the lung nine months, but presented no appearance of corrosion. It is deposited in the Pathological Museum of Shelby Medical College, Nashville.]

Following its removal, a copious discharge of pus took place, and although comparatively easy, he is yet very feeble.

Dr. P. inquired whether the members could suggest any other treatment in addition to that which he had already adopted, which consists of expectorants and a free use of cod-liver oil.

Dr. Currey suggested the propriety of administering the syrup of the phosphates of iron, etc., as a remedy from which the best results might be expected. Here was a case of abscess of lung, attended with great waste of tissue, a general decline of the entire system, all resulting from the presence of a foreign body; and now that it was removed, although we may reasonably expect that the disease has progressed so far as to be beyond the reach of any curative treatment, yet it seems that this preparation of iron is better calculated to fulfil all the indications of the case than any thing else at this time.

Dr. Hill coincided with the suggestion of Dr. Currey, and hoped that Dr. P. would adopt it and report result.

Dr. Hodsden described the case of a young man aged twenty-four,