nearly four thousand miles. But East and West, from the British and Dutch West Indies to the Galapagos group belonging to Ecuador, 600 miles out in the Pacific, 'the strategic islands' have come under review.

Many of our own West Indies depend upon America markets at their door, just as Ireland looks to England as her best customer by reason of that 'geographical propinquity' which Mr Lloyd George impressed upon Mr De Valera's delegates before the Free State was set up. At one time Holland offered her islands for $2,000,000. Denmark sold the Virgins, after Germany's secret bid had put up the price to the United States. Even the Robinson Crusoe' group, which Chile owns some 400 miles out, are proposed as naval bases— 'especially if the Chileans were assured that our object in fortifying them was for their own protection.'

Naturally, all these loud calculations do not make for Pan-American harmony. It is equally certain that Britain's good name is held in so high an esteem by these Republics, that it may fairly be termed an Iberian tradition. On the word of an Englishman,' is a common vow of Spanish speech; in Brazil any plausible show of order is in Portuguese expressed as 'For the English to see!' These are significant phrases. Nor is it forgotten that Britain favoured Independence long before it was won. But President Adams declined all proposals to take a hand in it; so a generation of wasting strife was imposed upon Spain's oppressed colonies in consequence. The naval service of the Cochranes; the Irish, English, and Scottish volunteers of 1817; the O'Learys and O'Connells whom Bolívar decorated, with O'Higgins and Murphy and Lynch of the West Coastthese men will never be forgotten in the pageant of Iberian Freedom.

It would be a mistake to suppose that the British Government is not alive to the importance of the Empty Continent as a future market, and a source of raw materials. In 1918 we sent out a special Diplomatic and Commercial Mission under Sir Maurice de Bunsen, G.C.M.G., and ten Republics were visited. The report to the Department of Overseas Trade is a model of terse shrewdness, of which the most salient point is the creation of a special Intelligence Bureau to take full

advantage of the large and favourable field for the expansion of our Trade,' which the Mission found in the stupendous spaces of South America. Much has happened since Sir Maurice de Bunsen received Los Descendientes de los Ingleses' in Valparaiso and Santiago, with perfect Castilian speech and graces equal to their own. The money-power of the United States has made great strides in the past decades as I have shown, whilst anti-British propaganda has done its work as well.

Mr Baldwin referred to this phase during his brief visit to Canada; it was also mentioned when seventy of our Chambers of Commerce met recently in Liverpool under the Presidency of Mr Gilbert C. Vyle. The source of much of this is evident,' Mr Vyle said darkly, adding that false news and views about us were likewise circulated abroad-'no doubt with an object.' The Chairman of this important body also regretted the 'mischievous pens' of certain British statesmen, who 'depict a state of affairs in England which is exceedingly discouraging, and as harmful to us as it is inaccurate.' And yet unpopular' we may be, as Sir Austen Chamberlain said, by reason of factors inherent in our national life and needs. Yet through sheer grit and force of character our people continue to progress, quand même, in spite of all opposition. In 1892, in 1846, and in 1832 voices of pessimism arose in our land. Nay, further back still, after the great surrender of Burgoyne near Saratoga Springs in the American Revolutionary War, a friend came hurrying to Adam Smith with the olden lamentation, Doctor-this is the ruin of Great Britain !' 'Sir,' returned the classic economist, in a phrase that should be set in letters of gold in every school and workshop of the land-'There is a great deal of "ruin" in the nation!'

IGNATIUS PHAYRE.

Art. 4.-MENTAL PATIENTS.

CASES that have recently come before the Courts have made it evident that it is still possible for perfectly sane persons to be sent to lunatic asylums and kept there for an indefinite period. Charles Reade's book, written many years ago, engendered among the great mass of the population a certain amount of suspicion of doctors, particularly of doctors in connexion with insanity. That suspicion is from time to time revived when the searchlight of the Courts is thrown upon some incident relating to the administration of the Law of Lunacy. Public opinion may sometimes be stupid and prejudiced, but it will always assume that where there is smoke there is fire, and that comparatively few cases of persons who are wrongfully confined in asylums are ever brought into public notice. Psychiatry, as a science, is still in its infancy, and no one has yet been able to give a satisfactory definition of insanity. Indeed, it is probably impossible to frame an exact and comprehensive definition. In different parts of the Lunacy Act different criteria are applied. In inquisition, the issue is whether a person is of unsound mind and incapable of managing himself and his affairs, though a person may be found incapable of managing his affairs, but capable of managing himself and not dangerous to others. In the reception order for a private patient the patient is described as a lunatic or idiot or person of unsound mind; but the reception order for a pauper patient incorporates the additional words, 'a proper person to be taken charge of and detained under care and treatment.' In cases of emergency, a person may be put under care where expedient either for the welfare of the person or for the public safety.

A person may be quite abnormal about many things without being insane. Mr Pigg, the huntsman in Surtees' inimitable tale, stated before the Judge in Lunacy that Mr Jorrocks was mad. On being asked his reasons for saying so, he said that he always cast back for a fox, and any man who did that was mad. No doubt things have greatly improved since Reade and Surtees wrote, but the prejudices of the public have

to be considered, and the public point of view is that the medical man is only too ready to certify, and without reason. The public has to be reassured, and that reassurance will have to be sought for in a way which will not leave the medical man with complete control. After all, laws are made for the public and not the public for the laws.

Unfortunately we have a great deal of mental sickness in our midst, much of which may be attributable to the conditions of modern life, and like physical illness, given a chance, it is temporary and curable. This result will not be attained by indiscriminate certification. Mental science receives very little attention in the medical curriculum, and yet it would appear that doctors are to be found wanting even in the rudiments of knowledge in psychiatry, who do not hesitate to sign certificates of insanity. It is felt that under the existing laws governing lunacy the safety of the liberty of the subject is not sufficiently safeguarded, and that such reform is needed as will allay public apprehension. That this apprehension is very general was manifested by the appointment in July 1924 of a Royal Commission on Lunacy and Mental Disorder, which issued its report in 1926 and summed up the problem in the following paragraph:

"The lunacy code should be recast with a view to securing that the treatment of mental disorder should approximate as nearly to the treatment of physical ailments as is consistent with the special safeguards which are indispensable when the liberty of the subject is infringed.'

This is a pious wish and avoids the issue of public apprehension caused by the existing state of the law and its administration. The keynote of the past has been detention; the keynote of the future should be prevention and treatment. But it is just here that the crucial difficulty of the whole matter resides. Owing to the special nature of the symptoms of mental illness, treatment must in many cases involve compulsion and restraint. This is the element which differentiates the treatment of insanity from the treatment of other illnesses. The patient suffering from an ordinary ailment is generally an intelligent co-operator in his own treat

ment and cure. He is able to appreciate what is being done for him and no coercive restriction of his liberty is needed. In many cases of insanity this is not so. The patient's intelligence and his ability to appreciate his position have been affected by his illness. His will has ceased for the time being to be rational. In such cases where there can be no voluntary submission to treatment, the treatment must of necessity be compulsory. It is round this problem of compulsion that the main controversies of our subject have centred. The liberty of the individual to manage himself and his property is a cardinal principle of our law; but it must always be remembered that the principle is not an inviolable one. No man can be a member of society without sacrificing some of his liberty. He is entitled to exercise his liberty of action in so far only as he does not thereby infringe the liberty of others. If he insists on exercising his liberty so as to cause danger to others he must suffer restraint. The price of liberty is conformity to the social order of conduct. Thus the citizen who abuses his liberty by infringing the criminal law has his liberty restricted by imprisonment. In the case of certain infectious diseases the sufferer has his liberty restricted by the requirement that he must be isolated from his neighbours lest he infect them with his malady. But herein lies the difference between them and the insane, they are deprived of their liberty by persons who being recognised by the public as experts in the work they undertake, inspire confidence. The ordinary medical man who has made no study of mental diseases cannot, and ought not to, expect that the same degree of confidence will be extended to him on a matter of which he obviously knows little or nothing. Such a man is prone to draw a definite line between the sane and the insane. There is no such line. Complete irresponsibility even among the admittedly insane is by no means universal. The degrees of mental instability are infinite and restriction of liberty is necessary only where the instability has reached the stage of being a danger to the sufferer himself or to his neighbours, or is such that the patient is incapable of managing himself. In slight or incipient cases compulsion is unnecessary and harmful. But it is in such