REPORT ON THE DULLUNDA LUNATIC ASYLUM
For the Year 1873.
By Surgeon-Major A. J. PAYNE, M.D., Superintendent.
ON my return from furlough early in May, I resumed charge of the Dullunda lunatic
asylum. During the first quarter of the year it was in the hands of Dr. Robert Bird.
Population.
Population.—Return No. 1 exhibits the following facts:—On 1st January 1873 there
remained in the asylum 377 persons, a number which exceeds the corresponding number
of 1872 by 52, and the average of ten years by 138. This progressive increase of the past
six years made its longest stride in 1873. Admissions were a little below those of 1872,
being 184 against 191, but higher by 30 than the average of ten years, and higher also than
in any single year of the ten except 1872. The re-admissions have somewhat fallen. There
were treated altogether in the asylum 581 persons; the largest number yet on record.
Overcrowding.
2. Respecting the evils of accumulation of numbers and overcrowding of the asylum,
I can add nothing to what I have already said, and shall only in this respect draw attention
to the corroborative events of the year as they come under review.
3. The daily average number continues to ascend; 369 in 1873, against 355 in 1872,
notwithstanding very numerous discharges ; but by the close of the year the numbers present
had fallen, with this as a cause, from 377 to 364.
Re-admissions.
4. The re-admissions are, as I remarked in my report for 1871, of little interest in
connection with asylum administration; repeated intoxication and return of criminals
removed for trial mainly comprising the group : the latter were nominal in 1873.
Cures.
5. Cures.—Recoveries have ranged high—138, exceeding by 63 the average of ten
years, and by 25 the highest number in the ten. It may be observed that there is no
corresponding increase of re-admissions to raise suspicion of premature discharge, and as
a circumstance of the year, therefore, a large number of recoveries not less genuine than
in other years may be accepted.
Sickness.
6. Sickness.—The daily average number sick does not differ materially from that of
1872.
Persons suffering from slight bruises and abrasions have been treated as out-patients,
and excluded from this calculation as in 1872. A heavy increase will be found in the
cases of phthisis to be charged against overcrowding; eighteen of these treated in the year,
seven of pneumonia, and two of pleurisy. The most numerous cases were those of dysentery,
which exceeded by five the number in 1872.
Mortality.
7. Mortality.—But although dysentery was so frequent, it was somewhat less fatal
than before, causing fourteen deaths, against nineteen in 1872. There were seven deaths in
all from phthisis, three from pneumonia, and one from pleurisy—a high proportion of fatal
pulmonary disease to total mortality. The deaths arising directly from nervous exhaustion
were few—that is, the cases in which no physical disease was interposed.
8. Reckoned on the mean daily number present, the deaths reached this year only
10.8 per cent., which is below the ratio of previous years, notwithstanding the increase of
pulmonary diseases; a fact which indicates the connection between these diseases and the
persistent and increasing defect of the asylum, overcrowding, as it works to intensify yearly
more and more the peculiar susceptibility of the insane. The deaths among the women
were particularly numerous, fifteen in a mean population of eighty-seven. The overcrowd-
ing is greater in the female ward. It is to be observed, however, that lung disease was
not so prevalent among the women as among the men.
Transfers.
9. Transfers.—The number of persons transferred in improved condition to the care
of friends (36) was again fairly high when compared with admissions, and the escapes were
nominal, numbering only two in the year. With reference to escapes, an opinion is expressed
in the Government resolution on the report of 1872, that measures should be taken to render
this asylum more secure. I take this opportunity therefore of repeating some remarks which
I submitted in a former year.
Escapes.
10. It is not, I think, desirable that a lunatic asylum should be surrounded by
impassable walls. The well-being of the people and all efficiency of management depend on
the vigilance of attendants, and nothing keeps these on the alert so surely as the consciousness
that escape is possible if they are negligent. Escapes must always be promptly detected, and
with a single trustworthy person in the place, almost every other result of negligence
is difficult to bring home to the culprit. Possibility of escape is therefore a most useful