NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
SECT. XVII.]
LUNATIC ASYLUMS.
87
two or more Keepers, who will direct the men in their work, and be respon-
sible for them until they return to their rooms.
78. Every Keeper accompanying a gang will be furnished with a whistle,
which he will sound in case of any serious difficulty or danger arising and
on hearing the whistle, all other Keepers in the neighbourhood must hasten
to render assistance.
79. Any unusual accident, such as an attempt to escape or commit
suicide or homicide, must be immediately reported to the superintendent.
80. In case of a patient receiving an injury, self-inflicted or otherwise,
the Keeper in charge must at once report the circumstance to the apothe-
cary. Should the injury be of a serious nature, it must be brought to the
notice of the superintendent immediately.
81. The food for the patients will be served out to them under the
immediate inspection of the European Keepers, who will see that it has been
properly cooked, and that each gets his due allowance. Meat and vegetables
for European and East Indian patients must be cut into small pieces, so that
they can be easily eaten with a spoon.
82. The first and second class Native Keepers will attend on European
and East Indian patients when eating their meals, and must help such of
them as may be unable to feed themselves.
83. In case of a patient refusing all sustenance, the circumstance must
be reported to the superintendent, and no attempt should be made to force
such to swallow food except in his presence.
84. Native patients during meals will be arranged in gangs, so that
those who refuse food, or are unable to feed themselves, can be observed, any
attempt on the part of one to take the rations of another prevented, general
order maintained, and assistance rendered when necessary. While the patients
are eating, the water-woman must be in attendance with drinking water, and
a pot of water should also be carried out with every gang proceeding to work.
85. In the evening, the patients must be collected, mustered, and shut
up in their wards at 6½ P.M., under the inspection of one of the apothecaries.
The persons of the patients, the rooms, and the furniture are then again to be
strictly examined, and any dangerous instrument or thing found is to be
removed. At this time, the apothecary will see that the earth closets and
urinals are in their proper places, and that there is a due supply of drinking
water in each room.
86. When patients are noisy or violent during the night, the European
and native keepers must speak to and endeavour to quiet them ; but should
that have no effect, the apothecary must visit and seek to pacify them. A
88
LUNATIC ASYLUMS.
[SECT. XVII.
few kind words, bit of tobacco, drink of cold water, or re-adjustment of
bedding will often have the desired effect.
All such occurrences are to be reported to the superintendent in the
morning.
87. No mechanical instruments of restraint are to be used under any
circumstances. If a patient is violent, destructive, or dangerous, he must be
put in charge of a number of keepers sufficient to make him feel that resist-
ance is useless, and violence impracticable.
88. All cases of sickness occurring by day or night are to be immediately
reported to the apothecary, who will have the patients removed to the
hospital for treatment.
89. No spirituous liquors or intoxicating drugs are to be introduced into
an asylum, and as the craving for these on the part of insanes is often so
strong as to lead them to adopt clandestine means of getting them, all keepers,
servants, and guards are to be specially warned on this subject. Any asylum
servant found transgressing this rule, or permitting others to do so, shall be
suspended or dismissed.
90. No letters or messages between patients and their friends must be
carried without the express sanction of the superintendent.
91. All asylum attendants are strictly prohibited from receiving presents
of any kind, either from patients or their friends, and from selling or making
presents of things to patients.
92. Keepers and servants must not quarrel with each other, or make a
noise, but attend to their duties in a quiet and orderly manner.
93. Servants are not to employ patients to assist them in their duties,
without express sanction ; and all servants who get patients to help them, will
be held responsible for their cleanliness and safety.
SUB-SECTION XII.
94. Superintendent. —The superintendent of an asylum shall be a
medical officer specially selected by Government, and is to abstain from
engaging in general practice, except when called to visit persons afflicted with
insanity. The appointment of Superintendent is on the same footing as
regards salary, &c., as a first class civil station.
95. He shall have the immediate charge and management of the asylum,
under the control of the Deputy Inspector General, Indian Medical Depart-
ment. His duties shall embrace the direction of every thing connected with
the treatment of the patients ; the regulation of diet, clothing, and work ; the
consideration of every thing bearing on the hygiene of the asylum, and its
inmates ; the control of the subordinate officers and servants ; the charge
of all Government property connected with the asylum ; the general
SECT. XVII.]
LUNATIC ASYLUMS.
89
superintendence of manufactures and gardens ; and the improvement and
embellishment of the asylum grounds.
96. In regulating the conduct and habits of the insane, he must care-
fully discriminate between acts which they are able, and those which they are
unable, to control ; and while exercising inflexible firmness, at the same time
manifest kindness, sympathy, and patience. He must also, as the patients are
necessarily left for a great part of the day in charge of the keepers, endeavour
to secure attendants as well qualified as possible for these important duties,
and seek, by considerate treatment, to render them contented with their
position, and by vigilant supervision to prevent harshness or negligence.
97. The superintendent shall regularly visit the asylum in the morning,
and as often during the day or night, as circumstances may render necessary.
At the morning visit he shall see every patient, inspect the premises, and give
such orders and adopt such measures as may be required. He shall also at
uncertain periods visit gangs at work, inspect the meals of the patients, and
see that the keepers are attending to their duties. At the Presidency quarters
are provided for the Superintendent on the Asylum grounds.
98. He shall also take care that the various records specified in Sub-
Section VII. are duly kept, and enter in the journal the case of each patient,
with the treatment and results.
SUB-SECTION XIII.
99. Apothecary and Assistant Apothecary.—The Subordinate Me-
dical Officers attached to an asylum will be specially selected by the Inspector
General, Indian Medical Department, and in addition to their specific duties,
must assist in the general duties of the asylum.
100. The medicines and medical stores will be under the care of the
Apothecary, and he will be held responsible by the superintendent for the
cleanliness, ventilation, and furniture of the rooms, hospital, and latrines,
and that each patient has a due supply of clean bedding and clothing. He
will, with the Assistant Apothecary, inspect all the lunatics every morning and
evening, and bring to the notice of the superintendent any who may appear
sick or excited ; see that the orders he may receive regarding the treatment and
management of patients are strictly carried out ; and will aid the superinten-
dent in the supervision of keepers, manufactures, and labour, and the general
maintenance of cleanliness, order, and discipline. He will also take care that
the various records are kept up, and returns prepared, and will have charge of
the Library and Reading Room.
101. The Assistant Apothecary will obey and assist the Apothecary
generally in the performance of his duties ; have all prescriptions properly
made up and administered ; keep accounts of expenditure of medical stores ;
and perform the ordinary hospital duties.
VOL. II.
M
90
LUNATIC ASYLUMS.
[SECT. XVII.
102. Both Warrant Medical Officers should try to win the confidence
and regard of all the patients, and in the case of those newly admitted, seek
to learn their history, and note their peculiarities and symptoms, for com-
munication to the superintendent.
103. In carrying out the orders of the superintendent regarding the
management of patients, they must display unwearied kindness, and never
allow any curative measure to acquire the appearance of a, punishment or
vindictive act. In case of misconduct on the part of a patient or servant, the
matter should be referred to the superintendent for his decision.
104. They will receive reports from the keepers regarding patients, &c.,
investigate every thing brought to their notice, and be ready at all hours to
render assistance in case of accident, turbulence, or sickness. They are to
report to the superintendent, at his visit, every circumstance that should be
brought to his notice, and in case of any emergency, to make an immediate
.report.
105. They will on alternate days inspect the rations after they have
been cooked, and the senior will report daily to the superintendent as to their
condition and quantity. Should an European keeper at meal time report that
any patient refuses food, the Apothecary will visit him and ascertain the
cause of the refusal.
SUB-SECTION XIV.
106. Matron.—The Matron of a Lunatic Asylum will be specially
selected by the Inspector General, Indian Medical Department, and will have
the general management and supervision of all the female patients.
(a.) She will be held responsible for the maintenance of cleanliness,
order and discipline, and will strictly carry out all the orders issued by the
Superintendent regarding the treatment and management of the female
patients.
(b.) It will be the duty of the Matron to see that the women are kept
clean in their person and clothing, and that the rooms and bedding are properly
aired. She will also see that the proper quantity of food is issued to each
patient under her charge, and in the case of any of them refusing their food she
will report the circumstance to the Senior Apothecary. She must bring to
the notice of the Superintendent at his morning visit any patient who may
appear sick, excited, or out of temper and she will invariably report to
him every other circumstance to which his attention should be directed.
(c.) The Matron will see that the female keepers, and the other female
servants, correctly perform their various duties, and must immediately report
to the Superintendent or Warrant Medical Officers every case of harshness,
neglect, or other misconduct.
SECT. XVII.]
LUNATIC ASYLUMS.
91
107. European Keepers.— T h e E u r o p e a n K e e p e r s s h a l l s e e t h a t a l l
the duties belonging to the native keepers and servants are duly performed,
and immediately report any misconduct or irregularities to the superintendent
or Warrant Medical Officers. When the superintendent is at his quarters,
they are to obey all orders given by the apothecary. They are to be present
at the opening of the cells in the morning, and with the assistance of the
native keepers, to inspect the person of every patient, and the furniture of
every room. They shall see that the patients are cleanly in their persons and
clothes, that furniture and fixtures are not injured or broken ; that rooms
and bedding are properly aired ; and that every part of the asylum and the
grounds is kept clean and in good order.
108. One Keeper will be present when the rations are served out to the
cook, and will take care that they receive the proper quantities, and that the
scales, weights, and measures are correct. At meal times they will inspect
the food, ar ŕange the patients in gangs, and see that the full quantity for
each is issued. In case of deficiency, attempt on the part of a servant to
purloin or receive food in barter, or refusal on the part of a patient to eat, an
immediate report must be made to the apothecary.
109. The Keepers will receive and take care that all orders regarding
the labour and exercise of the patients are duly carried out. One will specially
superintend work in the garden and grounds, and be responsible for garden
produce, and the other will look after and be responsible for manufactures.
They will also furnish to the superintendent, daily, statements of labour
executed, and deliver at his office articles of produce and manufacture.
110. Throughout the day, the European Keepers will maintain a strict
supervision over all parts of the asylum, taking care that the patients are
engaged in their allotted employments, that no quarreling takes place, and that
the Native Keepers are attentive, and do not maltreat or abuse their charges.
Should a patient become excited while at work or exercise, he
should be quietly removed by such a number of Native Keepers as will secure
acquiescence, without wrangling or struggling, and the circumstance be
reported to the superintendent
.
1 1 1 . I n t h e e v e n i n g , t h e s e K e e p e r s s h a l l , i n t h e p r e s e n c e o f o n e o f t h e
apothecaries, master all the patients, and with the assistance of the Native
Keepers, examine their persons and their rooms, taking possession of all such
dangerous articles as bits of iron, nails, pointed bones, pieces of glass, bits of
ropes, or clothing torn and twisted into ropes. They will then see the patients
duly arranged and made comfortable, lock the doors, detail the Native Keepers
whose turn it is to be on duty during the night, and see that each proceeds
to his post and understands his duties. They will then deliver all the keys
92
LUNATIC ASYLUMS.
[SECT. XVII.
to the apothecary, reporting the number of patients in each cell, and that
the doors have all been locked, and the necessary precautions adopted.
112. The Keepers will take the night duties on alternate nights, and
the one on duty will go round twice during the night and see that the Native
Keepers are present and attentive. He will also, in case of sickness or
excitement amongst the patients, be ready to assist the Native Keepers, and
in case of any emergency, is to call the apothecary. In the morning, the
Keeper will report the various occurrences of the night to the apothecary.
113. The Keepers are strictly to prevent the introduction of intoxi-
cating liquors and drugs into the asylum, and if such articles are found in the
possession of a patient, they will immediately seize them, and bring both the
patient and the Native Keeper in charge to the notice of the superintendent.
114. The Keepers are to prevent strangers from entering the premises,
unless they have an order of admission from the superintendent. When
friends are visiting patients, they are not to allow them to give articles of
food or money to the patients, without the special consent of the superintendent.
They are also strictly forbidden to receive, and must take care that the
Native Keepers do not receive presents of any kind from patients or their
friends. They are not to talk regarding the condition or extravagancies of
patients with friends or visitors, but to refer them for information to the
superintendent or apothecary.
115. The Keepers are not to permit letters or messages from patients
to be sent out, or letters or messages for them to be delivered, without the
sanction of the superintendent.
116. The European Keepers must perform their duties with firmness,
temper, and unwearied kindness, and endeavour by every means in their
power to win the confidence and regard of the patients. They must remember
that they are of unsound minds, and not responsible agents, and never, in
case of abuse or violence, retaliate by word or deed. They will find too,
that although the mind may be deaf to reason, the heart generally remains
open to kindness.
117. The Keepers shall obey all orders which shall from time to time be
given to them by the superintendent, and they shall keep an Order Book for
the reception of these.
118. The Keepers are not to be absent without leave, and if sick, or
absent on leave, must provide substitutes at their own expense.
119. The Keepers shall be appointed by the superintendent, in communi-
cation with the Inspector General, Indian Medical Department, and in case
of incompetence or misconduct, may be discharged, subject to the sanction
of the same authority.
SECT. XVII.]
LUNATIC ASYLUMS.
93
SUB-SECTION X.V.
120. Native keepers, 1st Class. —The 1st Class Native Keepers will
assist in carrying out all orders that may be issued regarding the patients,
establishment, or premises, by the superintendent, apothecaries, or European
Keepers.
121. They will each have a certain number of patients, attendants,
rooms, out-houses, and portion of premises committed to their care, and will
be held responsible that every duty connected with their charge is properly
and promptly performed, and for any neglect or misconduct on the part of
the inferior Keepers.
122. They will be present all day, except two hours for meals, and it
will be their especial duty to see that the rooms and premises generally are
duly swept and kept in good order, furniture kept clean, bedding and rooms
aired, and patients washed, bathed, neatly dressed, properly attended to, and
kindly treated.
123. They will receive the clean clothing and bedding for the patients
at the prescribed periods from the hospital steward, be responsible for every
article of these until sent back dirty, and will keep an account of such receipts
and returns in the Vernacular. They will also be responsible for the water
filters, food, dishes, basins, drinking pots, padlocks, and all other articles
committed to their charge, and must immediately report any breakage or loss.
124. They will also take care that the dry-earth system is duly carried
out in the latrines and the earth closets, by causing Keepers to attend the
patients when they go to a latrine, and seeing that the toties are constantly
in attendance and performing their duties properly. They must prevent
patients or attendants from defecating anywhere except in the latrines, and
drains from being used for sewage purposes, and will see that the soiled earth
from the latrines is carried to the proper place, and that rubbish and refuse
matters are at once removed.
125. They will be present at the opening and shutting of the cells,
they are to assist in mustering and searching the patients, and when meals
are served they will see that the food has been properly cooked, and is presented
in clean dishes, and that caste prejudices are not violated.
126. They will take the night duties on alternate nights, and the one
present will see that all the inferior Keepers are attentive, and in case of
misconduct, report the culprit to the European Keeper on duty. He will
also, should any patient prove persistently noisy or violent, summon the
European Keeper.
127. They are to avoid all wrangling or altercation with their subor-
dinates, and in case of any one of them disobeying orders, to report him
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LUNATIC ASYLUMS.
[SECT. XVII.
immediately to the apothecary. They will also be held responsible for all
the subordinates being present, and that they do not quarrel, make a noise,
or use bad language.
128. They must, under all circumstances, treat and see that the patients
are treated kindly, remembering that they are insane, and, therefore, objects
of pity, and not responsible for their words or acts. When abused or threatened
by a patient, they must never seek to retaliate, but try to maintain a cool
demeanour, and strive to calm him by some harmless concession or kind words.
If attacked by a patient, they must never return a blow, but summon
assistance by sounding their whistle.
129. They are strictly to obey the asylum rules regarding messages,
letters, forbidden articles, and presents.
130. The 1st Class Native Keepers, and all other subordinate attendants
and servants, will be appointed by the superintendent, subject to the sanction
of the Deputy Inspector General, Indian Medical Department, and in case of
misconduct, they may be fined or discharged by him, subject to the confirma-
tion of the same authority.
131. Applications for leave of absence from any of the Native Keepers
or servants must be made through the apothecary to the superintendent
during the morning visit. A Keeper or servant absent on any account for
more than twelve hours must provide a substitute.
SUB-SECTION XVI.
132. Second and Third Class Keepers and Female Keepers.
— T h e s e a r e p r o m p t l y t o o b e y a l l o r d e r s g i v e n t o t h e m b y t h e i r s u p e r i o r s , a n d
to perform all their duties in a quiet and orderly manner.
133. They are to be present during the entire day from the opening to
the shutting of the cells, except at meal times, when a certain number will
be allowed to go outside for a couple of hours.
134. Each will have a certain number of patients, and concomitant
duties assigned to him, and the more intelligent of the 2nd Class Keepers
will be selected as Overseers in the work-sheds, garden, and grounds.
135. When the doors are opened in the morning, and the rooms and
patients have been examined, each will collect the patients under his care,
have them cleanly washed and dressed, remove dirty bedding and clothing, and
arrange and keep tidy furniture and bedding.
136. They will also be present when the patients are eating their meals,
see that each takes his food properly, and assist such as cannot help them-
selves. In case of a patient complaining of the quality of, or refusing to take
food, they are to report the circumstance to an European Keeper.
9 5
SECT. XVII.]
LUNATIC ASYLUMS.
137. Throughout the day they will constantly be present with the
patients, to prevent escapes or accidents, and give such assistance and atten-
tion as may be. necessary. When the patients are at labour, they will obey
the Overseers, and see that the patients do not injure tools, waste materials,
or spoil the work. The Overseers will be responsible for the implements
issued, and will every evening hand them over to the European Keepers.
138. In the evening they will collect the patients for muster, examine
their persons and rooms for dangerous articles, and see them comfortably
arranged for the night. Should a patient become sick or violent during the
night, they will call the European Keeper on. duty.
139. They are not to allow patients to defecate or urinate, or do so
themselves, except in the appointed places, and when a patient goes to the
latrine, a Keeper must, as a rule, accompany him.
140. They are, under all circumstances, to treat the patients kindly,
and in case of any of them becoming excited, to summon assistance. Any
Keeper found negligent of, or using offensive language to, a patient will be
fined, and any one found guilty of cruelty will be discharged, and handed
over to a magistrate for punishment.
141. In case ofaccident, attempt to escape, or other emergency, those
on the spot will sound the whistles, with which each will be provided, and
all those hearing the alarm must at once hasten to give assistance.
142. They are strictly to obey the asylum rules regarding messages,
letters, forbidden articles, and presents; and, in default, will be severely
punished.
143. One half of the Keepers will be permitted to sleep at home every
alternate night, but must be again at their posts at gun-fire.
144. Besides the duties specified here, they must attend to any other
assigned to them by the superintendent, or under his sanction.
145. They are not to be absent without leave.
SCHEDULE.
FORM A.
Certificate of Medical Officer (see Sub-sections IV. and VIII).
I, the undersigned (here enter name and official designation), hereby
certify that I, on the 14 day of july.
at illeigeble, personally
examined (here enter name and. residence of lunatic), and that the said
illeigeble is a lunatic (or-an-idiot, or a person-of unsound
mind), and a proper person to be taken charge of, and detained under care