AN ABSTRACT 
OF THE 
Laws of the State of New York, 
IN REGARD TO THE COMMITMENT OF INSANE TO ASYLUMS, THEIR 
DETENTION AND DISCHARGE, AND COMPARISON OF THE SAME, 
WITH THE STATUTORY PROVISIONS OF ENGLAND. 
By JOHN P.J3-RAV, M. D„ LL. D., 
Medical Superintendent New York State Lunatic Asylum, Utica. 
[From the American Journal of Insanity, for January, 1879.] AN ABSTRACT 
OP THE 
Laws of the State of New York, 
IN REGARD TO THE COMMITMENT OF INSANE TO ASYLUMS, THEIR 
DETENTION AND DISCHARGE, AND COMPARISON OF THE SAME, 
WITH THE STATUTORY PROVISIONS OF ENGLAND.* 
JOHN P. GRAY, M. D., LL. D. 
Two broad considerations underlie this subject,—the 
welfare of the individual, and the safety of the public. 
The question of unnecessary interference with personal 
liberty, and the possibility of confounding sane and 
insane in the application of laws made to protect the 
latter, as well as society, are vital considerations. It is 
a fact and practically an axiom, that insanity implies or 
includes the necessity of special laws to meet the con- 
ditions which grow out of it, or in other words, to meet 
the symptoms and results of the disease itself. The 
laws upon the subject differ in various countries, 
as well as in the various States of our country. The 
objects everywhere are to determine what constitutes 
insanity, what degree or character of insanity produces 
loss of accountability for acts, or necessitates provision 
for the government of the person or property, and 
finally, confinement in hospitals, asylums, retreats, etc., 
for treatment and safety. 
*Address as President of the Association of American Medical Editors, 
delivered at Buffalo, N. Y., June 3, 1878. 2 
I do not propose here to enter into the subject gener- 
ally, but only in relation to the methods of determining 
the question of lunacy, in any given case, for the com- 
mitment to, detention in, and discharge from institu- 
tions, authorized under legal statutes, for the treatment 
and care of the insane. This subject has received great 
attention by men eminent both in the medical and legal 
professions, and the fact that the laws so widely differ 
both in their construction, established methods of pro- 
cedure, and the officers authorized to administer in their 
execution, tend to show the inherent difficulties that 
underlie it, both as a matter of law and social polity. 
Such laws necessarily call into requisition, in their pro- 
visions and execution, both medical and legal science; 
to determine the existence of disease, its degree, and 
the propriety of restraint by commitments, the deten- 
tion and the restoration to liberty. The determination 
of these questions must rest largely upon the individual 
judgment of medical men. Cases of insanity differ 
largely in the mental manifestations, social and general 
surroundings and conditions, and the natural character 
of the individual, hence the difficulty of any general 
rule applicable to all cases. 
In looking over the statutes of the several States, 
those of New York coincide more nearly with those 
of England than do those of any other State. The 
initial question is:—How is insanity to be deter- 
mined ? This issue was raised under the common 
law writ, de lunatico inquirendo, in any individual 
case suspected, and this went directly to the ques- 
tion of personal liberty. The laws of England require 
that any person brought within their provisions must 
be, certified on medical authority to be “ either a 
lunatic, or an insane person, or an idiot, or a person of 
unsound mind.” The statutes of New York, now in 
force, [Chap. 446 Laws of 1874. “An Act to revise the 3 
Laws of the State, relating to the care and custody of 
the insane; the management of the asylums for their 
treatment and safe keeping; and the duties of the State 
Commissioner in Lunacy.”] provide that “ the terms 
lunacy, lunatic, and insane, as used in this act, shall 
include every species of insanity, and extend to every 
deranged person, and to all (cases of) unsound mind 
other than idiots.” For idiots, the law has made certain 
special provisions. While it is difficult in a statute to 
enter into a scientific definition of insanity or do more 
than use a succession of terms which are rather syn- 
onymous th$n definitions of each other, it is found 
practicable to lay down some rule by which the insan- 
ity may be established, justifying and requiring confine- 
ment. What in law constitutes an insanity sufficient to 
confine, is involved in the provisions authorizing the 
medical certificates, as an initiatory proceeding, neces- 
sary in all cases. The certificates declare in terms that 
the person “ is insane, and a proper person for care and 
treatment under the provisions of Chapter 446, Laws of 
1874,” and recites the reasons therefor. This estab- 
lishes the lunacy and the necessity of confinement. 
The commitment becomes legal by the approval of the 
certificates by a judge, and thus the commitment and 
detention are made legal. 
CERTIFICATES OF INSANITY. 
England. 
Medical Certificates—Number and 
Time for Making.—Two medical cer- 
tificates must be made out, in the case 
of private patients, within seven clear 
days from the date of the examina- 
tion by the physicians; in the case of 
pauper insane only one is demanded, 
and the patient must be admitted 
within seven days of the examination. 
No medical certificates are required 
for chancery patients. 
New York. 
Medical Certificates—Number and 
Time for Making.—Tlie certificates of 
two physicians are required in all 
cases, and must he made out within 
ten days of the examination by the 
physicians, and the patient must be 
admitted within ten days of such ex- 
amination, or a new certificate is re- 
quired. 4 
England. 
New York. 
Qualifications.—Physicians making 
certificates must be in actual practice 
and duly registered. No medical at- 
tendant in an asylum can make a cer- 
tificate, and no physicians having pro- 
prietary interest in, or who receive 
any percentage of profits from an asy- 
lum. The medical certifiers must not 
be in partnership professionally, nor 
can the certificates be signed by the 
father, brother, son, partner or assist- 
ant of the person having charge of 
the patient, and no physician who 
signs the order or request for admis- 
sion to an asylum can sign the medi- 
cal certificate. 
Exceptions.—When there is but one 
medical man in a village, and the case 
is urgent, the patient may be admit- 
ted on this certificate, but must be 
examined after admission, and within 
three days, by two other physicians. 
Character of Certificate.—The facts 
upon which the opinion of a medical 
man is based must be stated in the 
certificate, and as observed upon the 
day of examination ; and every state- 
ment designated as a delusion, veri- 
fied ; and liear-say statements must be 
designated as such and the names of 
the persons giving them, must be 
mentioned. 
Approval of Certificates.—Exact cop- 
ies of all medical certificates (with 
any interlineations and erasures) must 
be sent to the Commissioners in Luna- 
cy within twenty-four hours after the 
admission of the patient, for approval, 
and if imperfect, they must be re- 
turned for correction, and if not cor- 
rected within fourteen days, the pa- 
tient must be discharged. 
Qualifications.—Physicians making 
certificates must have been in actual 
practice at least three years, of repu- 
table character, graduates of some 
incorporated medical college, a per- 
manent resident of the State, and all 
such qualifications must be certified 
to by a judge of a court of record. 
No physician can make a certificate 
committing a patient to an institution 
of which he is either the superin- 
tendent, proprietor, officer, or regular 
professional attendant. 
Exceptions.—N one. 
Character of Certificates.—They can 
only be made after a personal examin- 
ation of the party alleged to be in- 
sane, and must be according to forms 
prescribed by the State Commission- 
ers in Lunacy. The facts upon which 
the opinion of the medical man is 
based must be stated in the certificate 
and all duly certified under oath. 
Approval of Certificates.—All cer- 
tificates must be approved by a judge 
or a justice of a court of record of the 
county or district in which the alleged 
lunatic resides, and no person can be 
held in confinement for more than five 
days without such approval. 
Proofs.—Before approving or dis- 
approving of certificates of lunacy, 
the judge or justice may institute in- 
quiry, take testimony as to any alleged 
lunacy, and in his discretion call a 
jury in each case to determine the 
question of lunacy. 5 
Comments.—It will be observed that upon the matter 
of certificates the British and New York statutes agree 
in main essential points. In New York, the law gives 
three days more for making out certificates and getting 
a patient to the asylum; makes three years practice es- 
sential in an examiner in lunacy; while the English 
law specifies no time. The English law extends the list 
of those who are excluded by interest or relationship 
from making out certificates. The English law pre- 
scribes more specifically how the facts observed and ac- 
quired from others, and upon which opinion is based, 
shall be set forth in the certificate. The English law 
simply requires the approval of the certificate by a Com- 
missioner in Lunacy, and fourteen days are allowed for 
correcting defects, while in New York, the Commissioner 
in Lunacy only prescribes the form of certificate, while 
its approval must be by a judge or justice of a court of 
record in the judicial district where the alleged lunatic 
resided, and must be done within five days: furthermore, 
New York provides the still greater safeguard that be- 
fore approving the certificate, a jury may be impaneled 
on the option of the court. 
There is this further guarantee in the New York 
statute:—If any insane person, or any friend in his be- 
half, is dissatisfied with any decision or order of any 
county or special county judge, surrogate, judge of 
Superior Court, or Court of Common Pleas, or police 
magistrate, he may take an appeal, within three days, 
to the Supreme Court, who shall stay proceeding and 
forthwith call a jury to decide upon the facts of lunacy. 
The court shall, in making investigation, call at least 
two respectable physicians, and if the jury find the 
person sane, the justice shall discharge him or other- 
wise confirm the order sending to the asylum. 
Thus it will be observed that while the legal processes 
are simple and unobstructive, they nevertheless amply 6 
guard the rights of the individual, and in New York 
more especially place the whole, at every step, under 
judicial protection, though the intent of the law is evi- 
dently to rest the determination of the actual question 
of insanity upon medical authority. 
Since the law of 1874 went into operation, over sixteen 
hundred patients have been admitted into the Asylum 
at Utica, and I have reason to know that the approval 
of judges is not a mere ministerial act. The defects in 
certificates have been mainly failures by the medical 
examiners to give sufficient detail of the facts upon 
which they have based their opinions.* During the four 
years of the operation of the law, about two and one- 
lialf per cent of the certificates have included as insane, 
cases of intemperance with violence and peculiarities, 
of hysteria, and of meningitis. During the four years 
previous, about three per cent of the admissions were of 
this same class. 
As evidence of the good faith of medical men, and 
the integrity of public officers, and friends seeking ad- 
mission for patients at private charge, I can state that 
in an experience of twenty-eight years and the reception 
of ten thousand patients, there have been but three at- 
tempts to get persons into the asylum under improper 
motives, two public and one private. The other cases, 
admitted and discharged not insane, were of the classes 
already mentioned and criminals who had either suc- 
cessfully feigned insanity, or been acquitted by juries 
on the ground of insanity. 
* As this paper goes to press, a certificate is received at the Utica Asylum, 
with the following endorsement :—“ Not Approved. This certificate is 
entirely insufficient in form. The facts indicating the insanity, must he 
stated and should (in the true spirit of the law) be stated in such detail as to 
show upon the face and mere statement, that the patient is insane. A pe- 
rusal of the certificate will show that the examining physician has already 
stated his opinion,—he should also state his reasons for such opinion. They 
should be so particularly stated as to convince another reading them, that his 
opinion is well founded and correct.” 7 
Why should the law authorize the courts to approve 
practitioners generally as medical examiners, instead of 
constituting a small board of expert examiners? 
First,—The qualifications are expressly set forth in 
the law, and all medical men who possess them should 
be equally entitled to be made medical examiners. 
Second,—This permits the family physician, who is 
necessarily conversant with the facts of the case, to act 
as an examiner and to name to the family a second ex- 
aminer. It thus preserves the rule in regard to consult- 
ants, and gives the liberty to any family to say what 
physicians shall be brought within its confidence. 
Third,—If the public officer, or court designated only 
a few examiners, those might be appointed in whom 
neither the family, nor the family physician, had confi- 
dence, and a speculative class would be likely to seek 
and secure the appointments, and the office of examiner 
might soon become one of mere political reward, which 
the best men in the profession would avoid. 
Fourth,—In the sparsely settled districts, unless gen- 
eral practitioners were selected, great expense would en- 
sue from the examiners having to go long distances, or 
the alleged lunatic being transported to their offices. . 
Fifth,—An alleged insane person should always be 
examined at home under ordinary surroundings, with 
as little unnecessary official show, excitement, parade 
or exposure as possible, and the privacy of familes 
and family affairs should be as carefully kept as in any 
other disease. All this will be better secured where 
the family physician and confrere are employed. 
COMMITMENT OF THE INSANE. 
England. 
Commitment.—An order, a state- 
ment and the medical certificate al- 
ready mentioned are required. 
New York. 
Commitment.—An order, a state- 
ment recorded in the case-books of 
the institution, and two medical cer- 8 
England. 
Pauper lunatics are sent to asylums 
upon the order of the parish relieving- 
officer, acting with a clergyman or 
justice, accompanied by the certificate 
of a physician, surgeon or apothecary, 
and a statement which is to be filled 
out with exactness in the form of 
answers to questions, embracing the 
history of the patient. 
Private patients are admitted on an 
order signed by a relative, friend or 
some person authorizing them to be 
placed under restraint, and the per- 
son signing the order must have seen 
the patient within one month of its 
date, and this person becomes respon- 
sible for the payment of the expenses 
of the patient while in the asylum. 
This order is in the form of a written 
request, and must be accompanied by 
a statement similar to that required 
in the case of paupers, and two medi- 
cal certificates. 
Chancery patients are committed 
on “ an order signed by the committee 
appointed by the Lord Chancellor, and 
having an office copy of such appoint- 
ment annexed.” 
Criminal lunatics are committed 
under order of the courts. 
New York. 
tificates are required for public pa- 
tients, and a bond in place of the 
order for private patients. 
Pauper patients are admitted on an 
order of tlie Superintendent of the 
Poor, of the County in which the 
patient resides, accompanied by the 
two medical certificates already men- 
tioned. State paupers are commit- 
ted with certificates on an order of 
the Secretary of the Board of State 
Charities. 
Indigent persons, who are in such 
limited circumstances that they can 
not “ support themselves and their 
families under the visitation of in- 
sanity,” are committed under the or- 
der of the County Judge after proof 
of indigence, and that the insanity is 
not over a year's duration, accompa- 
nied by two medical certificates. 
Violent and dangerous insane,whom 
their friends neglect to confine, are 
also sent by the county judges, with 
two certificates. Criminal insane are 
committed by order of the courts. 
Private patients are admitted on a 
bond, executed by responsible parties, 
for their maintenance, and accompa- 
nied by twro medical certificates. 
A statement and history of all pub- 
lic and private patients, in all institu- 
tions, must be recorded in the case- 
books within three days after admis- 
sion. 
In county and municipal institu- 
tions for pauper insane, the commit- 
ments are under special Acts, which 
include commitment by local com- 
missioners of charities and correc- 
tions, police justices, and other mu- 
nicipal authorities, but in all cases 
the two medical certificates, judicially 
approved, are required. 9 
Comments.—It will be observed that in England, 
judicial authority is not invoked in commitment of any 
of the insane, and that private patients may be confined 
on an order, signed by any one, whether that person 
be a friend, relative, or even an entire stranger, and 
that a month may elapse between the time of this per- 
son seeing the alleged insane person, and granting the 
order for his admission, and that for pauper insane but 
one certificate is required. It is evident, that the guar- 
antees, both for private and pauper patients, are greater 
under the New York statutes, than under the English. 
SUPERVISION AND VISITATION. 
England. 
Supervision.—The officers charged 
with this duty are Masters in Lunacy, 
Commissioners in Lunacy, Visitors and 
Borough officers. There are two 
Masters (with salary) in lunacy who 
act as judges in all proceedings under 
the writ de lunatico inquirendo, who 
are barristers of ten years, or ser- 
geants-at-arms, and are appointed by 
the Lord Chancellor. 
There are six Commissioners in Lu- 
nacy, (with salary); three medical 
men and three barristers, who act 
as visiting commissioners; there are 
also six commissioners, non-visit- 
ing, and these latter are unpaid. 
Commissioners must have been in 
medical or legal practice five years. 
The board grant licenses to corpora- 
tions or private individuals to open 
asylums, visit and regulate asylums, 
report to the Lord Chancellor their 
condition, conduct and management, 
and all matters connected with the 
certified lunatics in England and 
Wales. They visit all licensed 
houses within the limits of certain 
territory, (four of these visits are made 
■conjointly by a medical and legal 
New York. 
Supervision.—Tlie officers charged 
with this duty in New York, are 
the State Commissioner in Lunacy, 
the State Board of Charities, Boards 
of Managers, Municipal Boards, and 
Commissioners appointed from time 
to time in special cases under courts. 
Special commissioners are appoint- 
ed by the Supreme Court, as the 
exigency arises in cases of writ de 
lunatico inquirendo. 
The Governor of the State has the 
power also to appoint at any time a 
special committee of visitation and 
examination. 
The State Commissioner in Lunacy 
(with salary), is appointed by the Sen- 
ate, on nomination by the Governor, 
and is charged with the visitation of 
all asylums, public and private, and is 
authorized to inquire into their man- 
agement and conduct, and report an- 
nually to the Legislature, and to make 
investigations into any alleged negli- 
gence or improper treatment of the 
insane, and in the name of the people 
of the State to issue an order for the 
remedy of any negligence, improper 
treatment or provision, and to report 10 
England. 
commissioner, and two by a legal 
commissioner,) and see all the inmates 
and examine as to the number ad- 
mitted, discharged, died, etc. Their 
jurisdiction is London and Westmin- 
ster, and county of Middlesex, and 
borough of Southwark and certain 
places of counties Surrey, Kent, Es- 
sex and “ every other place within the 
distance of seven miles from any 
other part of London, Westminster 
or Southwark.” 
All other houses or asylums are 
visited by Commissioners nominated 
annually in each borough, consisting 
of three or more justices, who act 
gratuitously, and one or more medical 
men \frho receive remuneration. 
Three, one a medical man, visit four 
times a year, and two other visits must 
be made by one or more of these 
commissioners, with two visits of 
Supervision by a barrister and medi- 
cal man. 
Two or more of the commissioners 
are empowered to visit all work- 
houses and jails where lunatics are 
confined. 
Lord Chancellor’s Visitors.—These 
are three, consisting of one legal and 
two medical visitors; they are re- 
quired to visit all chancery patients 
in asylums as well as those in private 
dwellings, all being under their juris- 
diction. 
In the Parliamentary report of the 
select committee, Dr. C. Lockhart 
Robertson presents the following tab- 
ulation, showing amount of visita- 
tions of private lunatics (not paupers) 
by chancery visitors and commis- 
sioners : 
The Statement. 
I. Chancery Visitors: Patients in 
asylums, one visit yearly ; patients in 
private dwellings, four visits yearly. 
New York. 
to tlie Supreme Court for relief if 
the order is disobeyed or negligently 
executed. 
He also visits all chronic lunatics 
in the custody of the county asylums 
organized under a license from the 
Board of State Charities, and those 
confined in municipal and city asy- 
lums, on all of which he reports an- 
nually to the Legislature. 
The State Board of Charities con- 
sists of eight members, one from each 
judicial district, appointed by the Sen- 
ate upon nomination of the Governor, 
and, excepting the Secretary, serve 
without pay, They are empowered to 
visit and examine into the condition of 
all charities of the State and all insti- 
tutions, public or private, where in- 
sane are under treatment or in cus- 
tody, to inquire into their government 
and management in all respects and 
the condition and treatment of pa- 
tients. 
Boards of Managers are appointed 
by the Senate, on nomination of the 
Governor, and have entire control and 
direction of State asylums and appoint 
the chief officers, establish by-laws, 
rules and regulations. A Board is 
appointed for each institution, the 
members of which act without pay. 
A majority is required to visit the 
asylums once a quarter, and the whole 
Board once a year. They have the 
power to regulate the admission and 
discharge of patients, and control 
and direct the entire financial affairs, 
and are required to report annually to 
the Legislature, within fifteen days 
after the opening of the session. 
These boards consist of eight or 
more members in each. 
The municipal boards are local 
boards created under laws authoriz- 
ing the organization of municipal and 
county asylums, over which they 
have full power of visitation and 
control. 11 
England. 
II. English Commissioners in Lu- 
nacy : Metropolitan licensed houses, 
six visits yearly; provincial licensed 
houses, two visits yearly ; lunatic 
hospitals, one visit yearly ; patients 
in private dwellings, one visit yearly ; 
(not chancery lunatics.) 
III. Scotch Commissioners in Lu- 
nacy : Patients in asylums, two 
visits yearly ; patients in private 
dwellings, one visit yearly. 
Licenses.—Persons or corporations 
desiring to take out licenses to open 
and carry on asylums, large or small, 
must make applications to the board 
at least fourteen days before a stated 
meeting of the Commissioners. This 
must state the number of patients, 
the sex and the arrangements for sep- 
aration, must give the place of the 
house, number and size of rooms, and 
quantity of land attached, and whether 
for public or private patients. 
New York. 
Licenses.—The State Commissioner 
is authorized to license private asy- 
lums, and every application must be 
accompanied by plans of the premi- 
ses, a description of the buildings, the 
extent and location of the grounds, 
the number of patients of each sex 
proposed to be accommodated, and 
after a personal examination of the 
premises, if he finds them suitable, 
he may grant the license. 
The State Board of Charities have 
power to grant licenses to counties to 
erect and organize asylums for the 
chronic insane, and to fix the rules 
and regulations for their government, 
and to withdraw the licenses if they 
are not properly conducted. 
Comments.—It will be observed that under the Eng- 
lish and New York statutes, there are visiting, control- 
ling and local boards, with varied functions and duties 
similar in character, and so constituted as to embrace 
all the interests, requirements and rights of the public 
and individual, growing out of the establishment of insti- 
tutions for the insane of every grade and character, and 
securing the personal liberty of those committed to 
them as far as the conditions arising;; in the disease will 
justify. 
In a recent report of a special Parliamentary commit- 
tee on lunacy laws, a printed quarto of six hundred 
pages, a large number of prominent men were examined; 
at the conclusion Pt. lion., The Earl of Shaftesbury, 
who has been on the English Lunacy Commission 
nearly fifty years, and permanent chairman since 1845, 12 
who was also member of the first committee of inquiry 
in 1828, and who had, by permission of the House of 
Lords, been attending this investigation, gave his views 
at great length. He stated: UI cannot recollect a sin- 
gle instance in which a patient has been brought into 
an asylum in whose case there was not sufficient grounds 
for saying that he was the proper subject for care and 
treatment. I can hardly recollect a single instance. I 
I see by referring to the evidence which has been given 
before your honorable committee that such is tlie.testi- 
mony of every man of experience who has been con- 
sulted on the matter.” To the question, “At the same 
time there is a feeling which has been expressed not 
only generally but by witnesses before the commit- 
tee, that a large number of persons are admitted into 
asylums in a state of sanity and kept there?” he replied, 
“I have no doubt those statements would be made, 
because I never knew the case of a patient, either un- 
der confinement or after confinement, who did not say 
that he had been most unjustly confined. I hardly 
know an instance. ” Question : “ At any rate it is your 
lordship’s opinion that the admission into an asylum 
is now sufficiently guarded?” Ans. “I think so.” 
Qnes. “Would you say the same with regard to 
their detention there; is it not the case that they are 
sometimes kept there longer than is necessary?” “I 
don’t think they are so now.” And he adds; “ It is a very 
great responsibility, to send out a patient upon the 
world both with respect to the patient himself, and in 
respect of society, before you are satisfied that he is 
cured, or, at any rate, in such a state that he can be 
safely trusted.” 
When Governor Hoffman, of New York, in 1874, ap- 
pointed General Francis C. Barlow, then Attorney Gen- 
eral of the State, Dr. Thomas Hun, of Albany, and M. B. 13 
Anderson, LL. D., President of Rochester University, a 
committee to examine into all institutions, public and 
private; they reported that no persons were improperly 
confined in the State, and no cases have since been re- 
ported either by the State Commissioner in Lunacy, 
or the State Board of Charities. Such facts go to show 
the efficiency of the law and the fidelity of the medical 
profession to the principles of science and humanity. 
DISCHARGE OF THE INSANE. 
England. 
Discharge of Patients.—Private pa- 
tients are discharged from any li- 
censed house or hospital by the 
direction, in writing, of the person 
who signed the order of admission. 
If such person be dead, absent or in- 
sane, then the husband or the wife, 
the father, the mother, then the 
nearest of kin, or finally the person 
who made the last payment of ac- 
count, may successively have power 
to give such order, and if there be no 
relative, friend or qualified person 
thus required to act to make the 
order, then the commissioners may 
direct the discharge as they see fit. 
In the case of pauper patients the 
guardians of any parish or union, or 
an officiating clergyman of any parish 
not under guardians, with one over- 
seer or any two justices of the county 
or borough may, in writing, direct the 
discharge or removal, provided they 
are not certified in writing as danger- 
ous or unfit to be at large, by the 
medical officer in charge, of any pau- 
per insane patient. Any two or more 
of the commissioners may discharge 
any pauper patient from houses li- 
censed by themselves, after two visits, 
with seven days intervening, if such 
patient is detained without sufficient 
New York. 
Private patients are discharged by 
the Managers of asylums, or may be 
removed by the persons executing the 
bond upon which they are received. 
Those who have been committed upon 
a warrant of a judge as dangerous to 
be at large, may be discharged upon 
the order of a justice of the Supreme 
Court, or if recovered may be dis- 
charged by the Board of Managers 
upon the Superintendent’s certificate 
of recovery. Indigent patients are 
discharged by the managers upon re- 
covery, and if not recovered in two 
years are liable to be removed after 
notification to the county judge, and 
they may also be discharged to the 
county authorities or friends by the 
board of managers. They may also 
be removed by their friends, though 
uncured, at any time before the expi- 
ration of two years, on presentation 
of a certified copy of a bond with 
sureties, approved by the County 
Judge of the county from which the 
patients were sent, the bond being 
filed in the county clerk’s office. This 
bond must guarantee “ the peaceable 
behavior, safe custody and comfort- 
able maintenance without further 
public charge ” of the lunatic so re- 
moved. 14 
England. 
cause ; and for like reasons two com- 
missioners, one a physician, may dis- 
charge any pauper patient from houses 
licensed by justices, but in all cases 
the medical attendant of the house 
or hospital shall be examined, if he 
desires to be, upon the subject before 
the discharge, and his statement shall 
be in writing and recorded. 
No lunatic, certified to be danger- 
ous, can be removed from any house 
or hospital, without first obtaining 
the consent of the Commissioners and 
Visitors. 
Criminal insane are discharged by 
the courts, after due investigation. 
New York. 
The managers, on the superintend- 
ent’s certificate of complete recovery, 
may discharge the pauper patient, 
and whether admitted as dangerous 
or not, “ upon the superintendent’s 
certificate that he or she is harmless 
and will probably continue so, and is 
not likely to be improved by further 
treatment in the asylum.” They may 
discharge any such patient to their 
friends upon the same guarantee as 
to safety, maintenance, &c., as men- 
tioned in regard to indigent patients. 
Criminal Insane.—A patient of the 
criminally insane class can only be 
discharged by an order of a justice of 
the Supreme Court, or a Circuit Judge, 
if upon due investigation it shall ap- 
pear safe, legal and right to make 
such order. 
Municipal and County Asylums.—In 
the counties of New York and Kings 
the County Commissioners of Charities 
having charge, discharge, but only on 
“ the certificate in writing of the phy- 
sician thereof, which certificate shall 
be filed and kept in said asylum, stat- 
ing that such discharge is safe and 
proper.” 
No insane person can be discharged 
from any poor house or county asylum 
(excepting New York and Kings) ex- 
cept upon an order of a county j udge 
or justice of the Supreme Court, 
“ founded upon satisfactory evidence 
that it is safe, legal and right to make 
such discharge.” Any other person 
or officer making such a discharge 
commits a misdemeanor and is pun- 
ishable by a fine of not more than 
$500 or less than $100, in the discre- 
tion of the court. 
Comments.—In England and America, the provisions 
for the discharge of the insane are essentially the same. 
As in the initiatory proceedings for confinement, the 15 
responsibility is mainly thrown upon the medical pro- 
fession, so also is the responsibility of discharge. In 
the discharge of pauper patients there is no practical 
difference in the two countries. In respect to private 
patients, the statutes of New York are more simple and 
practically effective. In New York the managers of each 
asylum have the power to discharge without formality, 
and even without the assent of the relations or guard- 
ians, while in England the consent of the person who 
signed the request or order for admission must first be 
obtained, or his successor, which may cause delay, 
annoyance, or even work to the detriment of the patient. 
Indeed the parliamentary report spoken of, shows that 
the institutions have frequently to invoke the influence, 
and sometimes the official power of the commissioners 
to compel the removal of private patients. In New 
York the bond, or as termed by the English law, the 
order, on which private patients are admitted, provides 
for discharge “whenever he shall be required to be 
removed by the managers or superintendent,” and in 
case of refusal, for the payment of “all expenses in- 
curred by the managers or superintendents, in sending 
such patients to his friends.” This compulsory provis- 
ion lies had to be enforced, at times, by the managers. 
Of course, in both countries the writ of habeas corpus 
stands as an ever-present protection against any possible 
wrong. This, however, has not been appealed to but 
three times at the Utica Asylum since my connection 
with the institution, in 1850,* and in these three cases the 
patients were immediately remanded to the Asylum by 
the courts. The statute of New York provides against 
any probability of unnecessary or improper detention of 
private patients, under any circumstances, as it makes the 
delivery of the patient, by the officers, to the friends, a 
mere matter of request at any time, as the friends are 
* Since tliat time there have been admitted 10,600 patients. 16 
not even put to the slight inconvenience of making a 
a formal order in writing, as in the English law, and 
the managers may discharge summarily. 
Since writing the above, the State Commissioner in 
Lunacy, Dr. John Ordronaux, has brought out a very 
valuable work, entitled u Commentaries on the Lunacy 
Laws of New York, and on the Judicial aspects of 
Insanity at Common Law, and in Equity, including 
Procedure in England and the United States.” He 
announces as the result of his observations and experi- 
ence as a Lunacy Commissioner, of his studies in 
revision of the laws, and of his examination of insti- 
tutions, that:— 
“In the organization also, and management of our asylums, and 
the provisions made for the care of the pauper and indigent insane, 
this State has made great progress; and lastly, in establishing a 
system of supervision of its insane wards, it has completed its 
guardianship of all departments ot its public charities. 
“ To unfold, therefore, the reason of the laws governing the civil 
and criminal status of the insane, has been the object to which I 
have addressed myself in these commentaries. They are designed 
to cover, not only the Revised Statutes of New York, but the 
whole field of those decisions in law and equity, which give rise to 
some of the most difficult questions in jurisprudence. And inas- 
much as they would be incomplete as a manual, without some dis- 
cussion of the practical methods of enforcing these laws, I haye 
added a chapter on Procedure; prefacing the whole work with a 
digest of adjudicated principles in the Jurisprudence of insanity, 
together with a synoptical sketch of the development of our 
statute law, herein, in the form of a History of Lunacy Legisla- 
tion in England and the United States.” THE 
AMERICAN JOURNAL OF INSANITY. 
The American Journal of Insanity is published quarterly, at the 
State Lunatic Asylum, Utica, N. Y. The first number of each volume 
is issued in July. 
Editor, 
JOHN P. GRAY, M. I)., LL. D., Medical Superintendent. 
Associate Editoks, 
JUDSON B. ANDREWS, M. D., 
EDWARD N. BRUSH, M. D., 
T. F. IvENRICK, M. D., 
WORTHINGTON W. MINER, M. D., 
Assistant Physicians. 
THEODORE DEECKE, Special Pathologist. 
TERMS OF SUBSCRIPTION, 
Five Dollars per Annum, in Advance. 
Exchanges, Books for Review, and Business Communications 
may be sent to the Editor, directed as follows: “Journal of 
Insanity, State Lunatic Asylum, Utica, N. Y.” 
The Journal is now in its thirty-fifth year. It was established 
by the late Dr. Brigham, the first Superintendent of the New York 
State Lunatic Asylum, and after his death edited by Dr. T. Romeyn 
Beck, author of “Beck’s Medical Jurisprudence;” and since 1854, by 
Dr. John P. Gray, and the Medical Staff of the Asylum. It is the 
oldest journal devoted especially to Insanity, its Treatment, Juris- 
prudence, &c., and is particularly valuable to the medical and legal 
professions, and to all interested in the subject of Insanity and Psy- 
chological Science