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    FROM THE BRITISH MEDICAL JOURNAL 3 MAR 1906:

    THE TREATMENT OF INEBRIETY.
    The Brentry Certified Inebriate Reformatory.
    THE report of this institution for 1905 is as usual interesting reading. 
    Its figures always prove something, and the most casual glance through 
    its pages shows that an eminently practical spirit inspires those who 
    are in charge of the work. Brentry has generally details of improvements
    to report. It is no mean final success that out of a population which might 
    well be called hopeless and impossible to reform, the medical officer 
    and managers can quote 66.12 per cent. as the proportion of those discharged 
    during the year who are, as far as can be ascertained, doing well and 
    keeping sober.
    The Medical Officer, Dr. Fleck, reports that the class of persons admitted 
    has not improved; the same deplorable material is still being supplied 
    to him to work upon. He has made searching inquiry into tbe mental condition 
    of all the 121 persons admitted during the year -34 females and 87 males. 
    For classification Dr. Fleek divides these into three simple but 
    comprehensive groups, namely:
    A. Congenitally defective ... Females  5 ... Males  17
    B. Mentally degenerate ......    "    15 ...   "    40
    C. Intellectually sound .....    "    14 ...   "    30
    Out of the defective groups 66.2 per cent. admit a history of alcoholism 
    in parents or near relations. The history of such a patient is usually 
    one of poverty, neglected childhood, scanty education, and want of proper 
    discipline and training in youth; thus 73.5 per cent. of all admissions 
    during the year had received only an elementary education and 19.83 per cent. 
    could neither read nor write. Dr. Fleck says:
    Many give a history of having been brought up "on the streets" "canals," 
    "gipsy encanipments", and suchlike places; in some cases running away 
    from their homes at an early age and commencing a criminal career before 
    they reached their majority. In my opinion a large percentage of these 
    owe their state in part to the poverty and thriftlessness of drunken parents.
    Dr. Fleck gives the results of a large number of discharges within the year. 
    Out of the discharges reported 66.12' per cent. are said to be doing well. 
    Among the discharged were:
    A. Congenitally defective ... Females  11 ... Males  12
    B. Mentally degenerate ......    "     30 ...   "    18
    C. Intellectually sound .....    "     26 ...   "    18
    These percentages practically coincide with the percentages of successes 
    and failures.
    The average gain in weight has been 9.66 lb. for every individual leaving 
    the reformatory. All inmates are expected to be industriously employed 
    for eight hours a day, and about 95 per cent. have complied with this
    regulation during the whole year, a fact which speaks excellently for 
    both the discipline and health of the inmates. Dr. Fleck believes that 
    gardening has advantages for the inmates over most other forms of employment.
    An imnportant part of the work on which Dr. Fleck lays stress, and which 
    he describes in detail, is the after-care of discharged inmates. Some 
    person is appointed to befriend, supervise, and report on every case; 
    and this work is now practically all done by the After-care Association,
    or by the Society for the Prevention of Cruelty to Children, according 
    to the section of the Act under which the inmates have been committed.
    The management has also with much good effect instituted a system of 
    classification among the inmates involving the earning of or deprivation 
    of privileges. It has also introduced a modified "mark" system by which
    inmates can earn money rewards, and this is found to work very well indeed.
    Dr. Fleck is to be congratulated on the scientific method in which he 
    is conducting a most difficult piece of work. A thoroughly satisfactory 
    system of treatment can be based only on a full recognition of the 
    element of mental defect which has already been shown to exist in a 
    large number of these cases, and we shall look to Dr. Fleck for valuable 
    contributions in the future to our knowledge in this direction.


    Linked toSamuel Francis DUNGEY

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