In every civilised community, however imperfectly the wish may be fulfilled, the desire is to do equal justice to all; to up hold the law as a terror to evil-doers, and the protector of the innocent.

The separate grouping of divers diseases in hospitals for their better treatment is a constant accompaniment of progress in medicine. Medical complaints have been separated from surgical ones; contagious diseases have been isolated from non-contagious diseases, and from one another; acute cases have been separated from chronic ones; those under medical treatment from those simply convalescent. But of late years, in the domain of mental science, so far from the separation of different groups becoming more and more definite, it might be held with some plausibility that for years back the tendency has been the other way. The asylum is becoming more and more an infirmary, a place for stowing away all the wreckage of our social system, all the flotsam and jetsam of disease and misfortune—a place where is thrown together everything in human nature troublesome and unsightly. Eccentric and dotard old people, deserted children whose feeble mental faculties made unusual demands upon the care of the poor-house matron, helpless paralytics, and many of the miscellaneous cases where bodily disease has brought with it mental feebleness, are all shoved into the District Asylum, to be kept till death walks them off.

In submitting the following short paper, I do so clearly realizing that deductions from limited observations present many sources of fallacy; also that even extended observations made in a limited area are very liable to error, and need correction by extended observation; that peculiarities of race, and circumstances connected with locality may even in such a matter as this exercise a marked influence. I trust, however, to hear the experience of others on the subject.

Much attention having recently been given (in the pages of this Journal and elsewhere) to the subject of the systematic training of asylum attendants, it occurred to me last autumn that some advantage might be gained in this direction by the instruction of the staff of this institution in “first aid to the injured,” as prescribed in the scheme of the St. John Ambulance Association. I accordingly announced my willingness to give the necessary course of five lectures and demonstrations, and having obtained the moral and pecuniary support of my Committee, who granted £5 in aid of the project, two classes were speedily formed, the one consisting of 28 men and the other of 39 women (the rules of the Association forbidding mixed classes). The fees were fixed at 2s. for the men and 1s. 6d for the women (including an anatomical diagram), and each pupil was advised also to purchase Shepherd's Manual of “First Aid,” price 1s., and an illustrated triangular bandage, price 6d. The staff of attendants and nurses were so eager to enter the classes that the only difficulty I had was to exclude a sufficient number for the necessary service of the patients on lecture evenings, which were Thursdays, at 8 p.m. Each lecture occupied about an hour, and another half hour or so was subsequently devoted to practical work, in which I had the aid of the assistant medical officer, Dr. Taylor. The subjects embraced in the course included a general outline of the structure and functions of the body, with special reference to the formation of the skeleton, the course of the circulation, and the functions of respiration and the nervous system. The practical instruction was in the application of bandages, chiefly triangular, the various extemporary means of arresting hæmorrhages, and of protecting and securing fractured bones, and what to do in certain emergencies, such as suffocation, drowning, burns, scalds, &c.; also in the removal of the injured on ambulance stretchers and otherwise, and (for women) a cursory account of the principles of nursing. The classes were from time to time questioned on the subjects of the lectures, the matron undertaking the supervision of the practical work of the women. By these various means I think I may say that the pupils were well taught, and at the examination by Surgeon-Major Hutton, one of the Association examiners, out of 15 men and 19 women presenting themselves, 15 men and 18 women passed with credit. The examination was of a fair and specially practical character, the women having, in addition to vivâ-voce questioning, a paper of six questions to answer in writing, and the men being subjected to an extended examination in ambulance drill.